甲状腺癌左颈部淋巴结清扫术后双侧乳糜胸：一例报告
Bilateral chylothorax after left neck lymphadenectomy for thyroid cancer: A case report.
作者信息
Sun Wencong, Wang Xinhui, Ding Chao, Wang Yichen, Su Zijie, Li Guoqing
机构信息
Department of Thyroid Surgery, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, Henan, 450003, China.
Department of Geriatric, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, Henan, 450003 China.
出版信息
Heliyon. 2024 Feb 13;10(4):e26178. doi: 10.1016/j.heliyon.2024.e26178. eCollection 2024 Feb 29.
INTRODUCTION
Chylothorax is caused by lymphatic chyle fluid leaking back through the thoracic duct and accumulating in the pleural cavity. It is related to a thoracic duct injury or occlusion. It is rare to have bilateral chylothorax after cervical lymph node dissection for thyroid cancer diagnosis.
CASE REPORT
A 28-year-old woman was admitted to our hospital with bilateral hypoechoic thyroid nodules and cervical lymph node abnormalities. She underwent thyroidectomy and lymphadenectomy but developed chylothorax 3 days after surgery. She was treated with bilateral thoracic drainage, electrolyte supplementation, and somatostatin, and was discharged 17 days post-treatment.
CONCLUSION
Bilateral chylothorax is a rare complication of thyroid cancer surgery. Early diagnosis and treatment, especially the detection of dyspnea, are key. Also, unobstructed bilateral thoracic drainage, improved surgical skills, and reduced thoracic duct injuries can help reduce complications.
引言
乳糜胸是由于淋巴乳糜液通过胸导管反流并积聚在胸腔内所致。它与胸导管损伤或闭塞有关。因诊断甲状腺癌而行颈部淋巴结清扫术后出现双侧乳糜胸的情况较为罕见。
病例报告
一名28岁女性因双侧甲状腺低回声结节及颈部淋巴结异常入住我院。她接受了甲状腺切除术和淋巴结清扫术，但术后3天出现了乳糜胸。对她进行了双侧胸腔引流、补充电解质和使用生长抑素治疗，治疗17天后出院。
结论
双侧乳糜胸是甲状腺癌手术的一种罕见并发症。早期诊断和治疗，尤其是对呼吸困难的检测，是关键。此外，通畅的双侧胸腔引流、提高手术技巧以及减少胸导管损伤有助于减少并发症。
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