Clinical analysis of chylothorax in 49 neonates after surgery for congenital disease
10.3760/cma.j.cn112434-20201015-00465
- VernacularTitle:新生儿先天性心脏病术后乳糜胸49例临床诊治分析
- Author:
Chaoying ZHANG
1
;
Yunxia SUN
;
Yumei LIU
;
Yuan REN
;
Shaoru HE
Author Information
1. 广东省人民医院 广东省医学科学院新生儿科，广州 510100
- Keywords:
Chylothorax;
Congenital heart disease;
Postoperative complications
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2022;38(2):71-74
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the cause and treatment of chylothorax after surgery for congenital heart disease(CHD) in newborns.Methods:A retrospective analysis was made to the clinical data of 49 newborns with chylothorax after surgery for CHD within the period from January 2009 to December 2019. These newborns were aged from from 1 day to 28 days with the weight from 2.0 kg to 4.1 kg. The complete transposition of great arteries was performed in 13 cases, coarctation of the aorta/ interruption of the aortic arch in 13 case, right ventricular outflow tract reconstruction/ Blalock-Taussing shunt in 9 cases, total anomalous pulmonary venous connection in 8 cases, ventricular septal defect repair and atrial septal defect repair in 4 cases, ligation of patent ductus arteriosus in 1 case and persisten truncus arteriosus in 1 case. Chylothorax occurred in the right in 19 cases, left side in 20 cases, bilateral in 9 cases and the pericardium in 1 case. The diagnosis was made at the time from 1 day to 22 days after the surgery with an average of 8 days.Results:43 patients were cured(87.75%), 41 cases(83.67%) were cured with diet and support therapy, the course lasted from 4 days to 65 days with an average of 11 days; 1 cases, because of the poor effect of diet and support therapy, was given pleural injection of high-sugar combined with octreotide treatment; 1 case received thoracic duct ligation as the conservative therapy was ineffective; 6 cases of death due to heart failure/ severe pulmonary hypertension after operation, and parents gave up.Conclusion:Individualization conservative therapy is the first choice for chylothorax, while timely surgery can raise the survival rate and save the hospitalization time and the cost.
