Department of Neonatology, Kanagawa Children's Medical Center, Yokohama, Japan.
Department of Biostatistics, School of Medicine, Yokohama City University, Yokohama, Japan.
J Neonatal Perinatal Med. 2024;17(2):247-254. doi: 10.3233/NPM-230171.
The prognosis of congenital chylothorax and ascites ranges from spontaneous resolution to death, but no established examination exists to predict the prognosis. We aimed to develop a clinically useful method to evaluate lymphatic abnormalities using indocyanine green (ICG) lymphography in infants with congenital chylothorax and ascites.
We retrospectively evaluated infants with congenital chylothorax and chylous ascites who underwent ICG lymphography in our hospital between 2012 and 2022. The ICG lymphography findings was evaluated. We defined the dermal backflow in the trunk as the lymphatic flow from the end of the limb back through the lymphatic vessels on the surface of the trunk. The association between the dermal backflow in the trunk and clinical outcomes, as follows, are investigated: the duration of the drainage period, the duration of endotracheal intubation, and the length of hospital stay.
Twenty infants had a dermal backflow in the trunk, and ten did not. Clinical outcomes in infants with and without dermal backflow in the trunk were as follows (median): the duration of the drainage period (20 vs. 0 days, p = 0.001), the duration of endotracheal intubation (12 vs. 2 days, p = 0.04), and the length of hospital stay (62 vs. 41 days, p = 0.04), respectively. In multivariate linear regression analysis adjusted for gestational age, the duration of the drainage period was correlated with the dermal backflow in the trunk [exp(B) = 2.62; p = 0.003].
The dermal backflow in the trunk in ICG lymphography was useful in predicting the clinical course of congenital chylothorax and ascites.
先天性乳糜胸和乳糜性腹水的预后范围从自发性缓解到死亡不等，但目前尚无确定的检查方法来预测预后。我们旨在开发一种使用吲哚菁绿（ICG）淋巴造影术评估先天性乳糜胸和乳糜性腹水患儿淋巴管异常的临床实用方法。
我们回顾性评估了 2012 年至 2022 年在我院接受 ICG 淋巴造影术的先天性乳糜胸和乳糜性腹水患儿。评估了 ICG 淋巴造影的结果。我们将躯干的皮肤回流定义为从肢体末端回流到躯干表面淋巴管的淋巴液。研究了躯干皮肤回流与以下临床结果之间的关系：引流期持续时间、气管插管持续时间和住院时间。
20 例患儿有躯干皮肤回流，10 例患儿无躯干皮肤回流。有和无躯干皮肤回流的患儿的临床结果如下（中位数）：引流期持续时间（20 天比 0 天，p=0.001）、气管插管持续时间（12 天比 2 天，p=0.04）和住院时间（62 天比 41 天，p=0.04）。在调整胎龄的多变量线性回归分析中，引流期持续时间与躯干皮肤回流呈正相关[exp(B)=2.62；p=0.003]。
ICG 淋巴造影中的躯干皮肤回流有助于预测先天性乳糜胸和乳糜性腹水的临床病程。
