【摘要】 目的　探讨颈乳糜瘘及乳糜胸的发生原因、治疗方法及预防措施。方法　６２ 例乳糜瘘中３５ 例采用单纯局部压迫，２１ 例采用持续负压引流加局部压迫，６ 例手术缝扎。４ 例乳糜胸１ 例采用胸腔穿刺，３例开胸结扎胸导管。结果　采用单纯压迫的３５例，３０例痊愈，５ 例失败，经手术治疗痊愈，平均愈合时间为１５．２（９～２６）ｄ。采用持续负压引流加局部压迫的２１ 例１８ 例痊愈，３ 例失败，经手术治疗愈合，平均愈合时间为１１．６（９～１５）ｄ。手术缝扎６例，均Ⅰ期愈合。１ 例乳糜胸保守治愈，３ 例经保守治疗（２～３）ｄ 无效，开胸结扎胸导管痊愈。结论　日丢失乳糜液小于５００ ｍ Ｌ或经保守治疗超过１周无效者，手术缝扎。乳糜胸经保守治疗（２～３）ｄ 无效者，开胸结扎胸导管。更多还原

【Abstract】 Objective To study the cause,therapeutic method and preventive measures of cervical chylous fistula and chylothorax.Methods A total of 1704 sides(in 1546 cases) were treated by neck dissection from Feb,1972 to Dec,1997.Among them,chylous fistula occurred in 62 cases, and chylothorax in 4 cases.35 of them were treated by local pressure dressing alone,21 by continuous vacuum drainage plus local pressure dressing,6 by operative ligation.Among the 4 cases of chylothorax,one was treated by thoracocentesis, 3 by thoracic duct ligation in thoracotomy.Results In the 35 cases treated by local pressure dressing alone,30 of them were cured completely, 5 failed and were cured by a further operation.The mean healing period was 25 days (from 9 to 26 days). Among the 21 cases treated by continuous vacuum drainage plus local pressure dressing,18 were cured,3 failed and were cured by a later operation. The mean healing period was 11.6 days (from 9 to 15 days).Those 6 cases treated by operative ligation recovered successfully. 1 case of chylothorax were cured by conservative treatment.After 2～3 days conservative treatment,the 3 failed cases were cured by thoracicduct ligation in thoracotomy.Conclusion In cases with daily chylous fluid lose lower than 500 ml, conservation treatment is recommended; and in those with conservation treatment lasts for 1 week but failed,operative ligation is better.In those with chylothorax and 2～3 days conservative treatment but failed,the best choice is thoracicduct ligation in thoracotomy.更多还原