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[乳糜胸作为冠状动脉旁路移植手术的一种并发症]

[Chylothorax as a complication of coronary artery bypass grafting operation].

作者信息

Szabó Miklós, Jáger Margit, Krizsó Eszter, Gilányi Ibolya, Leny Andrij, Szűcs Géza, Csánky Eszter

机构信息

Miskolci Semmelweis Ignác Egészségügyi Központ Nonprofit Kft. és Egyetemi Oktató Kórház Tüdőgyógyászati Osztály Miskolc Csabai kapu 9-11. 3529.

出版信息

Orv Hetil. 2012 Apr 8;153(14):553-8. doi: 10.1556/OH.2012.29341.

Abstract

The authors present the case of a 72-year-old woman who underwent coronary bypass grafting. Left sided chylothorax due to accidental dissection of a thoracic duct branch developed 2 months after sternotomy. As conservative therapy has failed, surgical pleurodesis was performed successfully. Chylothorax is a rare and underestimated complication of coronary bypass grafting. The worldwide increasing number of coronary artery bypass grafting surgeries makes it important to pay attention to this condition. Thus diagnosis of the chyle is relatively easy by its high chylomicron and triglyceride content, but identification of the etiology and its treatment is sometimes challenging for the physician. The treatment of chylothorax is usually conservative. The main goal is to keep the volume of the chyle under control. The number of surgical interventions because of chylothorax is increasing due to an increase of iatrogenic etiology.

摘要

作者介绍了一位72岁接受冠状动脉搭桥手术的女性病例。胸骨切开术后2个月,因意外切断胸导管分支导致左侧乳糜胸。由于保守治疗失败,成功实施了手术性胸膜固定术。乳糜胸是冠状动脉搭桥手术中一种罕见且易被低估的并发症。全球范围内冠状动脉搭桥手术数量不断增加,因此关注这种情况很重要。乳糜因其高乳糜微粒和甘油三酯含量,诊断相对容易,但病因的识别及其治疗有时对医生来说具有挑战性。乳糜胸的治疗通常是保守的。主要目标是控制乳糜量。由于医源性病因增加,因乳糜胸进行手术干预的次数正在增加。

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