Division for Minimally-invasive Lymph Vessel Therapy, Department of Diagnostic and Interventional Radiology, University of Bonn, Bonn, Germany.
Department of Radiology, University of Bonn, Venusberg-Campus 1, 53105, Bonn, Germany.
Sci Rep. 2023 Oct 17;13(1):17643. doi: 10.1038/s41598-023-42197-9.
The purpose of this retrospective study was to evaluate the occurrence of infectious complications and inflammatory reactions after transabdominal lymphatic-interventions. 63 lymphatic-interventions were performed in 60 patients (male/female: 35/25; mean age 56 [9-85] years) [chylothorax n = 48, chylous ascites n = 7, combined chylothorax/chylous ascites n = 5]. Post-interventional clinical course and laboratory findings were analyzed in the whole cohort as well as subgroups without (group A; n = 35) and with peri-interventional antibiotics (group B; n = 25) (pneumonia n = 16, drainage-catheter inflammation n = 5, colitis n = 1, cystitis n = 1, transcolonic-access n = 2). No septic complications associated with the intervention occurred. Leucocytes increased significantly, peaking on post-interventional day-1 (8.6 ± 3.9 × 10 cells/mL vs. 9.8 ± 4.7 × 10 cells/mL; p = 0.009) and decreased thereafter (day-10: 7.3 ± 2.7 × 10 cells/mL, p = 0.005). CRP-values were pathological in 89.5% of patients already at baseline (40.1 ± 63.9 mg/L) and increased significant on day-3 (77.0 ± 78.8 mg/L, p < 0.001). Values decreased thereafter (day-15: 25.3 ± 34.4 mg/L, p = 0.04). In subgroup B, 13/25 patients had febrile episodes post-interventionally (pneumonia n = 11, cystitis n = 1, drainage-catheter inflammation n = 1). One patient developed biliary peritonitis despite continued antibiotics and underwent cholecystectomy. Baseline leucocytes and CRP-levels were higher in group B than A, but with comparable post-interventional profiles. Clinically relevant infectious complications associated with transabdominal lymphatic-interventions are rare irrespective of peri-interventional antibiotic use. Post-interventional elevation of leucocytes and CRP are observed with normalization over 10-15 days.
本回顾性研究旨在评估经腹淋巴介入后感染并发症和炎症反应的发生情况。60 例患者（男/女：35/25；平均年龄 56 [9-85] 岁）共进行了 63 次淋巴介入[乳糜胸 n=48，乳糜性腹水 n=7，乳糜胸/乳糜性腹水联合 n=5]。在整个队列以及无（A 组；n=35）和有围介入期抗生素（B 组；n=25）的亚组（肺炎 n=16，引流管炎 n=5，结肠炎 n=1，膀胱炎 n=1，经结肠通道 n=2）中分析了介入后的临床过程和实验室发现。无与介入相关的脓毒症并发症发生。白细胞显著增加，于介入后第 1 天（8.6±3.9×10 细胞/mL 与 9.8±4.7×10 细胞/mL；p=0.009）达到峰值，随后逐渐下降（第 10 天：7.3±2.7×10 细胞/mL，p=0.005）。C 反应蛋白值在基线时（40.1±63.9mg/L）已有 89.5%的患者升高，在第 3 天（77.0±78.8mg/L，p<0.001）显著升高。随后下降（第 15 天：25.3±34.4mg/L，p=0.04）。B 亚组中，13/25 例患者术后发热（肺炎 n=11，膀胱炎 n=1，引流管炎 n=1）。尽管继续使用抗生素，仍有 1 例患者发生胆汁性腹膜炎，并进行了胆囊切除术。B 组的白细胞和 C 反应蛋白基线值高于 A 组，但术后表现相似。无论是否使用围介入期抗生素，经腹淋巴介入相关的临床相关感染并发症均较为罕见。术后白细胞和 C 反应蛋白升高，10-15 天后恢复正常。
