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目的探讨一种简单、有效的预防食管癌切除术后乳糜胸的方法。方法选择2004年5月-2007年4月收住入院的220例食管癌患者,无进食梗阻者,随机分为试验组(A组)和对照组(B组)各110例。A组术前口服20%脂肪乳剂注射液进行标记胸导管,B组术前常规准备。术中观察各组胸导管充盈状态和损伤情况,术后统计各组乳糜胸及其他并发症,χ2检验进行统计分析。结果A组均明显充盈(100%);B组能见到胸导管34例(30.9%),但均呈不充盈状。术后乳糜胸A组0例,B组4例(3.6%),两组比较差异有统计学意义(P<0.05)。结论脂肪乳剂术前标记胸导管方法简单、可靠,能基本避免食管癌术后乳糜胸的发生。
Objective To explore a simple and effective method of preventing chylothorax after resection of esophageal cancer. Methods A total of 220 patients with esophageal cancer hospitalized admitted to our hospital from May 2004 to April 2007 were randomly divided into experimental group (A group) and control group (B group) with 110 cases each. A group of preoperative oral administration of 20% fat emulsion for marking the thoracic duct, group B preoperative preparation. Intraoperative observation of each group thoracic duct filling status and injury, postoperative statistics of each group chylothorax and other complications, χ2 test for statistical analysis. Results All patients in group A were significantly filled (100%). In group B, thoracic duct was seen in 34 cases (30.9%), all of which showed no filling. There were 0 cases in group A and 4 cases in group B (3.6%) after operation. There was significant difference between the two groups (P <0.05). Conclusion The preoperative labeling of thoracic duct with fat emulsion is simple and reliable, and can basically prevent the occurrence of postoperative chylothorax in esophageal cancer.