Yamaguchi T, Watanabe G, Kotoh K, Yamashita A, Sugiyama S, Misaki T
First Department of Surgery, Toyama Medical and Pharmaceutical University, Japan.
Kyobu Geka. 1996 Dec;49(13):1085-7.
A case of 64-year-old male who developed chylorrhea at 2 days post coronary artery by-pass grafting, is reported. He was managed conservatively for 3 weeks. But chylothorax was not improved, he was treated operatively. Analysis of his lymphocyte subpopulations in peripheral blood were performed during the course of chylothorax. Lymphocytepenia became apparent and subpopulation of T cell were decreased gradually. The subpopulation of CD 4(+) cell decreased, while the subpopulation of CD 8(+) increased. The CD 4(+) cell/CD 8(+) cell ratio decreased consequently till 7th day after 2nd operation. Although the replenishment of nutritional deficiencies using TPN allows prolonged conservative management for chylothorax patient, the deterioration in cellular immunocompetence can not be prevented at present. It is necessary to take great care about infection for chylothorax patient.
报告一例64岁男性在冠状动脉搭桥术后2天出现乳糜漏。他接受了3周的保守治疗。但乳糜胸未改善，遂接受手术治疗。在乳糜胸病程中对外周血淋巴细胞亚群进行了分析。淋巴细胞减少明显，T细胞亚群逐渐减少。CD4(+)细胞亚群减少，而CD8(+)细胞亚群增加。第二次手术后直至第7天，CD4(+)细胞/CD8(+)细胞比值随之下降。虽然使用全胃肠外营养补充营养缺乏可使乳糜胸患者进行较长时间的保守治疗，但目前尚无法预防细胞免疫能力的恶化。对于乳糜胸患者，必须高度警惕感染。
