Ng Boon Hau, Nik Abeed Nik Nuratiqah, Abdul Hamid Mohamed Faisal, Soo Chun Ian, Low Hsueh Jing, Ban Andrea Yu-Lin
Pulmonology Unit, Department of Medicine, Faculty of Medicine Universiti Kebangsaan Malaysia Medical Centre Kuala Lumpur Malaysia.
Department of Anaesthesiology and Critical Care, Faculty of Medicine Universiti Kebangsaan Malaysia Medical Centre Kuala Lumpur Malaysia.
Respirol Case Rep. 2020 Jul 15;8(7):e00624. doi: 10.1002/rcr2.624. eCollection 2020 Oct.
Chylothorax is an uncommon cause of pleural effusion. Recurrent chylous effusions are often resistant to conservative treatment and many need surgical intervention. We report a 69-year-old woman with refractory idiopathic chylothorax resistant to medium-chain triglyceride diet and intermittent thoracentesis. Lymphangiography and lymphoscintigraphy failed to identify the site of leakage. We initiated continuous positive airway pressure (CPAP) 12 h before and 48 hours after talc pleurodesis. Chest drain was removed at day 3 and she was discharged at day 5. To our knowledge, this is the first case of successful resolution of idiopathic refractory chylothorax with CPAP ventilation used in tandem with talc pleurodesis.
乳糜胸是胸腔积液的一种罕见病因。复发性乳糜性胸腔积液通常对保守治疗有抵抗性，许多患者需要手术干预。我们报告了一名69岁女性，患有难治性特发性乳糜胸，对中链甘油三酯饮食和间歇性胸腔穿刺术均无反应。淋巴管造影和淋巴闪烁造影未能确定漏出部位。我们在滑石粉胸膜固定术之前12小时和之后48小时开始持续气道正压通气（CPAP）。第3天拔除胸腔引流管，第5天患者出院。据我们所知，这是首例将CPAP通气与滑石粉胸膜固定术联合使用成功治愈特发性难治性乳糜胸的病例。
