Birchard S J, Smeak D D, Fossum T W
Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Ohio State University, Columbus 43210.
J Am Vet Med Assoc. 1988 Jul 1;193(1):68-71.
Thoracic duct lymphangiography and ligation were done on 15 dogs with idiopathic chylothorax. Lymphangiography revealed thoracic lymphangiectasia in all dogs; none had a thoracic duct rupture. Lymphangiography immediately after ligation demonstrated missed branches of the thoracic duct in 4 of the 15 dogs. Eleven of the 15 dogs are alive and doing well. Eight of the 11 had no radiographic or clinical signs of pleural effusion (mean follow-up, 31.5 months; range, 4 to 75 months). The other 3 living dogs had persistent effusion; 2 were successfully managed with a pleuroperitoneal shunt (follow-up, 15 months) or pleurodesis (follow-up, 5 months), respectively, and 1 was not treated because the effusion was mild and the dog did not have clinical signs of disease (follow-up, 14 months). Four of the 15 dogs died or were euthanatized because of persistent effusion (mean follow-up, 11.5 months; range, 3 to 24 months). Considering the lack of treatment alternatives for dogs with idiopathic chylothorax, these results support thoracic duct ligation as a treatment method for dogs.
对15只特发性乳糜胸犬进行了胸导管淋巴造影和结扎术。淋巴造影显示所有犬均有胸淋巴管扩张；无一例有胸导管破裂。结扎后立即进行的淋巴造影显示，15只犬中有4只存在胸导管分支遗漏。15只犬中有11只存活且状况良好。11只存活犬中有8只无胸腔积液的影像学或临床体征（平均随访31.5个月；范围4至75个月）。另外3只存活犬有持续性积液；其中2只分别通过胸腹分流术（随访15个月）或胸膜固定术（随访5个月）成功治疗，1只因积液较轻且犬无疾病临床体征而未接受治疗（随访14个月）。15只犬中有4只因持续性积液死亡或实施安乐死（平均随访11.5个月；范围3至24个月）。考虑到特发性乳糜胸犬缺乏其他治疗选择，这些结果支持胸导管结扎术作为犬的一种治疗方法。
