Lindhorst E, Miller H A, Taylor G A, Gotzen L
Department of Surgery, University of Marburg, Germany.
J Trauma. 1998 Mar;44(3):540-2. doi: 10.1097/00005373-199803000-00023.
Recent reports on the treatment of chylothorax postulate a benefit to ventilator therapy, especially using positive end-expiratory pressure (PEEP). This report describes the use of mechanical ventilation with PEEP in the management of a 24-year-old male motorcyclist who sustained a ligamentous Chance fracture of the thoracic spine at the T6-7 level with bilateral traumatic chylothorax. Treatment of the chylothorax consisted of high PEEP ventilation, bilateral chest tube thoracostomies, and total parenteral nutrition. The chylothoraces resolved within 4 days of treatment and mechanical ventilation was stopped. Ventilator therapy of traumatic chylothorax and the physiologic grounds for its use are discussed. A review of the literature and experimental evidence seem to suggest that ventilator treatment of traumatic chylothoraces is effective.
近期有关乳糜胸治疗的报告推测，机械通气治疗有益，尤其是使用呼气末正压（PEEP）。本报告描述了一名24岁男性摩托车手的治疗情况，该患者胸6 - 7水平发生胸椎韧带性Chance骨折并伴有双侧创伤性乳糜胸，治疗中采用了带PEEP的机械通气。乳糜胸的治疗包括高PEEP通气、双侧胸腔闭式引流术及全胃肠外营养。乳糜胸在治疗4天内消退，机械通气停止。本文讨论了创伤性乳糜胸的机械通气治疗及其使用的生理依据。文献回顾和实验证据似乎表明，创伤性乳糜胸的机械通气治疗是有效的。
