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根治性颈部清扫手术后发生的乳糜瘘是令人不安和具有潜在严重性的一种并发症。在左侧胸导管和右侧淋巴管区域仔细地进行手术常可预防乳糜瘘的发生,一旦发生了乳糜瘘则仅用压力敷料常不足以堵塞溢漏的管道。病人应再行手术找出裂口并予以结扎。乳糜液的丧失可迅速耗尽体内体液、蛋白质和电解质的储存。仔细检查血清电解质和蛋白质并准确地予以补偿是重要的。本文对颈根部淋巴管和乳糜瘘的解剖,生理,手术方法与治疗加以讨论。
Cholesteric fistulae that occur after radical neck dissection are uncomfortable and potentially serious complications. Careful surgery in the left and right lymphatic vessels often prevents the occurrence of chylous fistulas, which are often not enough to block spilled tubing in the event of a chylous fistula. Patients should be reoperated to find the gap and ligation. The loss of chylomicrons quickly depletes the body fluids, the storage of proteins and electrolytes. It is important to examine serum electrolytes and proteins carefully and compensate exactly. This article discusses the anatomy, physiology, surgical methods, and treatment of lymphatic and chylous fistulas in the neck.