Tomobe Yutaro, Mizuguchi Uiko, Shimotakahara Akihiro, Shimojima Naoki, Okazaki Kaoru
Division of Neonatology, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan.
Division of Surgery, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan.
Biomed Hub. 2020 Sep 21;5(3):907-911. doi: 10.1159/000509903. eCollection 2020 Sep-Dec.
Etilefrine, a sympathomimetic agent, is reportedly effective against postoperative chylothorax. However, its effectiveness in treating congenital chylothorax was unknown. We report herein a case of refractory congenital chylothorax treated with etilefrine in a late preterm neonate with massive fetal chylous pleural effusion. The chylothorax was unresponsive to previous treatments, including dietary and pharmacological treatment and thoracic duct ligation. The pleural effusion decreased after intravenous etilefrine was begun on day of life (DOL) 84 and resolved after the addition of chemical pleurodesis with OK-432 on DOL 90. This combination therapy may be a viable treatment option for cases of congenital chylothorax that are unresponsive to other treatments.
依替福林是一种拟交感神经药，据报道对术后乳糜胸有效。然而，其治疗先天性乳糜胸的有效性尚不清楚。我们在此报告一例晚期早产儿难治性先天性乳糜胸的病例，该患儿在胎儿期有大量乳糜性胸腔积液。该乳糜胸对先前的治疗，包括饮食和药物治疗以及胸导管结扎均无反应。在出生后第84天开始静脉注射依替福林后，胸腔积液减少，并在出生后第90天加用OK-432进行化学性胸膜固定术后积液消退。这种联合治疗可能是对其他治疗无反应的先天性乳糜胸病例的一种可行治疗选择。
