Jain Avani, Singh Shashank Nath, Singhal Pawan, Sharma Man Prakash, Grover Mohnish
Department of Otolaryngology (ENT), Sawai Man Singh Medical College and Attached Group of Hospitals, Jaipur, Rajasthan, India.
Laryngoscope. 2015 Jul;125(7):1624-7. doi: 10.1002/lary.25171. Epub 2015 Jan 30.
To study the effectiveness of octreotide in managing chyle fistula neck and its effect on duration of hospitalization.
Prospective study.
A total of 19 patients with chyle fistula following neck dissection over a period of 10 years were included in the study. All the patients first underwent conservative management of the chyle leak, including suction drainage, pressure dressings, bed rest, and nutritional modifications. In all of the cases, chyle leak persisted despite conservative management. Octreotide was started in a dose of 100 µg subcutaneously every 8 hours for 5 days in cases with low-output leaks and for 7 days in cases with high-output leaks. In all of the cases, the duration of chyle leak after starting treatment with octreotide and the duration of hospitalization was recorded.
Chyle leak stopped in all the cases using octreotide. The mean duration of hospitalization was 13.8 days.
Chyle leak stopped within 5 days of starting octreotide in the low-output cases and within 7 days in the high-output cases. This permitted early resumption of a regular oral diet and reduced morbidity associated with chyle fistula. The rapid response and minimal side effect profile make octreotide a promising addition to the medical management of a chyle fistula.
研究奥曲肽治疗颈部乳糜瘘的有效性及其对住院时间的影响。
前瞻性研究。
本研究纳入了10年间19例颈部清扫术后发生乳糜瘘的患者。所有患者首先接受乳糜漏的保守治疗，包括负压引流、加压包扎、卧床休息和营养调整。在所有病例中，尽管进行了保守治疗，乳糜漏仍持续存在。对于低流量漏出的病例，奥曲肽以每8小时皮下注射100μg的剂量给药5天；对于高流量漏出的病例，给药7天。在所有病例中，记录开始使用奥曲肽治疗后乳糜漏的持续时间和住院时间。
所有病例使用奥曲肽后乳糜漏均停止。平均住院时间为13.8天。
低流量病例在开始使用奥曲肽后5天内乳糜漏停止，高流量病例在7天内停止。这使得患者能够早日恢复正常饮食，并降低了与乳糜瘘相关的发病率。快速的反应和最小的副作用表明奥曲肽有望成为乳糜瘘药物治疗的补充手段。
