Xu Kai-feng, Hu Xiao-wen, Tian Xin-lun, Gui Yao-song, Wang Lan, Li Long-yun, Zhu Yuan-jue
Department of Respiratory Medicine, Peking Union Medical College Hospital & Chinese Academy of Medical Sciences, Beijing 100730, China.
Zhonghua Yi Xue Za Zhi. 2011 Feb 22;91(7):464-8.
To analyze the clinical characteristics of chylous effusion and boost its diagnostic and therapeutic level.
A retrospective analysis was conducted for 123 cases of chylous effusion at our hospital between January 1990 and December 2009.
The main clinical manifestations of chylous effusion included dyspnea (55.3%), edema (26.8%), abdominal distention (22.8%) and loss of weight (17.1%). Hypoalbuminemia was common (45.5%) and it was even more so in patients with idiopathic lymphopathies or of unknown causes (95.2%). The positive rates of identifying chylous effusion by Sudan III test, high triglyceride levels (> 1.25 mmol/L), lymphangiography or lymphangioscintigraphy were 89.1%, 80.6%, 70.6% and 89.5% respectively. Its common etiologies included injury (14.6%), malignancy (9.0%), infections (7.3%), lymphatic disorders or idiopathic lymphopathies (40%), drug-associated (2.4%) or associated with underlying disorders (16.3%). Efficacy was achieved in 63.6% of the patients and 21.8% died.
Chylous effusion is a special type of serous effusion with multiple causes. Its clinical manifestations are often nonspecific. But malnutrition is common. Its causes are identified after a systematic evaluation. Treatment modalities include dietary modification, management of underlying causes and surgical approaches.
分析乳糜性积液的临床特征，提高其诊断和治疗水平。
对我院1990年1月至2009年12月期间收治的123例乳糜性积液患者进行回顾性分析。
乳糜性积液的主要临床表现包括呼吸困难（55.3%）、水肿（26.8%）、腹胀（22.8%）和体重减轻（17.1%）。低蛋白血症较为常见（45.5%），在特发性淋巴管病或病因不明的患者中更为明显（95.2%）。苏丹III试验、高甘油三酯水平（>1.25 mmol/L）、淋巴管造影或淋巴管闪烁造影诊断乳糜性积液的阳性率分别为89.1%、80.6%、70.6%和89.5%。其常见病因包括损伤（14.6%）、恶性肿瘤（9.0%）、感染（7.3%）、淋巴系统疾病或特发性淋巴管病（40%）、药物相关（2.4%）或与基础疾病相关（16.3%）。63.6%的患者治疗有效，21.8%的患者死亡。
乳糜性积液是一种特殊类型的浆液性积液，病因多样。其临床表现往往不具有特异性。但营养不良较为常见。通过系统评估可明确病因。治疗方式包括饮食调整、基础病因管理和手术治疗。
