Van Aerde J, Campbell A N, Smyth J A, Lloyd D, Bryan M H
Am J Dis Child. 1984 Oct;138(10):961-4. doi: 10.1001/archpedi.1984.02140480063019.
During a 22-year period, 12 cases of spontaneous chylothorax in newborns were diagnosed at a large pediatric tertiary care center. Seven infants had right-sided effusions; only one effusion occurred on the left. Severe bilateral accumulations occurred in four nonimmune hydropic premature infants. The diagnosis was made by the milky appearance and/or the presence of more than 80% lymphocytes in the pleural fluid. Early diagnosis of the pleural effusion as chyle was associated with a less protracted course than when diagnosis was delayed. The total pleural fluid losses varied from 130 to 3,308 mL. Initial treatment included chest taps and/or drains in all the infants and mechanical ventilation in six. Oral feedings with standard or medium-chain triglyceride formulas were given in five; total parenteral nutrition was administered in seven. The conditions of two infants with copious and persistent drainage improved following surgery. All but one infant survived, and the chylothoraxes never recurred.
在22年的时间里，一家大型儿科三级护理中心诊断出12例新生儿自发性乳糜胸。7例婴儿有右侧胸腔积液；仅1例积液发生在左侧。4例非免疫性水肿早产儿出现严重双侧胸腔积液。诊断依据为胸腔积液呈乳状外观和/或胸腔积液中淋巴细胞超过80%。与诊断延迟相比，早期诊断胸腔积液为乳糜液与病程不那么迁延有关。胸腔积液总丢失量在130至3308毫升之间。初始治疗包括对所有婴儿进行胸腔穿刺和/或置管引流，6例进行机械通气。5例给予标准或中链甘油三酯配方的口服喂养；7例给予全胃肠外营养。2例胸腔大量持续引流的婴儿术后病情改善。除1例婴儿外，所有婴儿均存活，且乳糜胸未再复发。
