儿童不同病因乳糜胸的临床表现及治疗：一家医学中心的经验
Presentations and management of different causes of chylothorax in children: one medical center's experience.
作者信息
Lin Chien-Heng, Lin Wei-Ching, Chang Jeng-Sheng
机构信息
Division of Pediatric Pulmonology, China Medical University Children's Hospital, Taichung 404, Taiwan - Department of Biomedical Imaging and Radiological Science, College of Health Care to College of Medicine, China Medical University, Taichung 404, Taiwan.
Department of Biomedical Imaging and Radiological Science, College of Health Care to College of Medicine, China Medical University, Taichung 404, Taiwan - Department of Radiology, China Medical University Hospital, Taichung 404, Taiwan - School of Medicine, College of Medicine, China Medical University, Taichung 404, Taiwan.
出版信息
Biomedicine (Taipei). 2017 Mar;7(1):5. doi: 10.1051/bmdcn/2017070105. Epub 2017 Mar 3.
BACKGROUND
Chylothorax in children is a relatively rare cause of pleural effusion. However, it is usually a common complication of cardiothoracic operations like open-heart surgery. Other etiologies for chylothorax, such as trauma or malignancy, occur more common in adults and rare in children. To explore the etiologies of chylothorax in children, this study analyzed the pediatric patients that were admitted in to onea medical center.
METHODS
We retrospectively reviewed the medical records of the pediatric patients that were admitted to this tertiary transfer center with a diagnosis of chylothorax during the period of 1995 to 2005.
RESULTS
A total of 22 patients (15 females and 7 males) with chylothorax were enrolled in our study. The etiologies for chylothorax were the following: a complication of cardiothoracic surgery in 14 patients (63.6%), congenital chylothorax in 5 patients (22.7%), association with neuroblastoma in 2 patients (9.1%), and congenital nephrotic syndrome in 1 patient (4.6%). All patients required medical therapy. Chest tube drainage was necessary to provide for twenty patients (90.9%), and surgical intervention was necessary to perform for 3 patients (13.6%). Four patients (18.2%) expired due to other causes.
CONCLUSION
Cardiothoracic surgery was the most common cause of chylothorax in children at the institution surveyed. Medication and chest tube drainage were effective in treating most of these chylothorax-afflicted patients. In addition, early recognition, medication, and performing surgical intervention when necessary are important measures to avoid a catastrophe.
背景
小儿乳糜胸是胸腔积液相对少见的病因。然而，它通常是心脏直视手术等心胸手术常见的并发症。乳糜胸的其他病因，如创伤或恶性肿瘤，在成人中更常见，在儿童中罕见。为探讨小儿乳糜胸的病因，本研究分析了一所医学中心收治的儿科患者。
方法
我们回顾性分析了1995年至2005年期间收治于该三级转诊中心且诊断为乳糜胸的儿科患者的病历。
结果
本研究共纳入22例乳糜胸患者（15例女性，7例男性）。乳糜胸的病因如下：心胸手术并发症14例（63.6%），先天性乳糜胸5例（22.7%），与神经母细胞瘤相关2例（9.1%），先天性肾病综合征1例（4.6%）。所有患者均需药物治疗。20例患者（90.9%）需要胸腔闭式引流，3例患者（13.6%）需要手术干预。4例患者（18.2%）因其他原因死亡。
结论
在所调查的机构中，心胸手术是小儿乳糜胸最常见的病因。药物治疗和胸腔闭式引流对大多数乳糜胸患儿有效。此外，早期识别、药物治疗以及必要时进行手术干预是避免灾难的重要措施。
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