摘要
目的探讨肺癌术后中心静脉置管渗漏误诊为乳糜胸的原因及治疗方法。方法对我院2004年6月～2010年10月收治的肺癌术后中心静脉置管渗漏误诊为乳糜胸6例的临床资料进行回顾性分析。结果 6例均为Ⅱb～Ⅲa期肺癌,行肺叶切除、系统淋巴结清扫术,术后5 d胸腔引流量700～900 ml/d,乳糜试验阳性,误诊为乳糜胸。采用低脂饮食保守治疗2～3 d无效,拔除中心静脉导管,胸腔引流量明显减少,确诊为中心静脉置管渗漏。全组中心静脉导管平均留置8 d,胸腔引流时间平均10 d,平均住院18 d,随访6个月摄X线胸片未见胸腔积液。结论肺癌术后胸腔引流量持续超过正常,应排除中心静脉置管渗漏,并结合临床综合分析,以免误诊。
Objective To investigate the cause and treatment of leakage from central venous catheter misdiagnosed as chylothorax in post-operative patients with lung cancer.Methods 6 post-operative patients with lung cancer and leakage from central venous catheter admitted into our hospital from June 2004 to October 2010 were misdiagnosed as having chylothorax,and the clinical data were retrospectively analyzed.Results 6 patients with lung cancer of stage Ⅱb-Ⅲa underwent lobectomy and mediastinal lymph node dissection,5 days after operation,the chest tube drainage was 700 to 900 ml/d,chyle test was positive,and they were misdiagnosed as having chylothorax.After 2-3 days of low-fat diet,conservative treatment was invalid,the central venous catheter was then removed,chest drainage was significantly reduced,and diagnosis of leakage from central venous catheters was established.Central venous catheters were retained for 8 days in average,chest tube drainage were retained for 10 days,average hospital stay was 18 days,and chest X-ray showed no pleural effusion during a 6-month follow-up.Conclusion The leakage of central venous catheter should be excluded if pleural drainage lasts longer than normal after lobenectomy in lung cancer patients,and clinical data should be analyzed comprehensively to avoid misdiagnosis.
出处
《临床误诊误治》
2011年第9期26-27,共2页
Clinical Misdiagnosis & Mistherapy
关键词
肺肿瘤
术后并发症
中心静脉置管渗漏
误诊
乳糜胸
Lung neoplasm
Postoperative complication
Central venous catheter leak
Misdiagnosed
Chylothorax
