Clinical features of congenital chylothorax: analysis of 11 cases
10.3760/cma.j.cn113903-20230813-00114
- VernacularTitle:先天性乳糜胸的临床特点：11例分析
- Author:
Yu CHEN
1
;
Hong WEN
;
Mingyuan WU
Author Information
1. 浙江大学医学院附属妇产科医院新生儿科，杭州 310006
- Keywords:
Chylothorax;
Thoracentesis;
Drainage;
Amnion;
Nutritional support
- From:
Chinese Journal of Perinatal Medicine
2024;27(2):89-95
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To summarize the clinical features and prognosis of congenital chylothorax and provide a basis for rational diagnosis and treatment.Methods:Clinical data of 11 cases of congenital chylothorax treated in the Department of Neonatology of Women's Hospital, School of Medicine, Zhejiang University from January 2020 to December 2022 were retrospectively collected and analyzed. Intrauterine intervention, clinical manifestations, auxiliary examinations, management strategies, outcomes, and postnatal follow-up were summarized using descriptive statistical analysis.Results:All the patients were born by cesarean section at the gestational age of (35.7±2.2) weeks (32 +1-39 +0 weeks). The male-to-female ratio was 4∶7. Four cases were complicated by fetal edema. Nine cases received intrauterine treatment, including thoracentesis in six cases, thoraco-amniotic shunting in one case, and thoracentesis combined with thoraco-amniotic shunting in two cases. Six patients had mild asphyxia. All 11 patients developed respiratory distress within 24 h after birth and were found with pleural effusion by chest X-ray and ultrasound. After a series of treatments, including chest drainage, respiratory support, sequential nutritional therapy, and octreotide, nine cases were cured and discharged from the hospital, while two cases died of pulmonary collapse after withdrawing treatment (both complicated by fetal edema). No recurrence of chylothorax was reported in the nine patients and their growth and development were normal during a follow-up to 3-22 months after birth. Conclusions:Patients with congenital chylothorax are prone to intrapartum asphyxia and respiratory distress after birth. Most patients can survive and have good outcomes after intrauterine intervention and postnatal comprehensive treatment.
