The clinical characteristics and outcomes of 21 cases of neonatal congenital chylothorax
10.3760/cma.j.issn.1673-4912.2025.11.006
- VernacularTitle:21例新生儿先天性乳糜胸的临床特征及结局分析
- Author:
Yan CUI
1
;
Ling ZHANG
1
;
Hongxiang GUO
1
;
Xiuyong CHENG
1
Author Information
1. 郑州大学第一附属医院新生儿科 450052
- Publication Type:Journal Article
- Keywords:
Chylothorax;
Preterm infants;
Full-term infants;
Erythromycin
- From:
Chinese Pediatric Emergency Medicine
2025;32(11):832-836
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To summarize the clinical characteristics and treatment outcomes of neonatal congenital chylothorax (CC) and to provide evidence for improving its clinical management.Methods:The clinical data from 21 neonates diagnosed with CC and admitted to the Department of Neonatology, the First Affiliated Hospital of Zhengzhou University, from February 2014 to June 2024 were retrospectively reviewed. According to gestational age, patients were classified into preterm group (<37 weeks) and full-term group (≥37 weeks). The clinical manifestations, therapeutic approaches, and outcomes were analyzed.Results:A total of 21 children with CC were included, including 16 males and five females, with an average gestational age of (36.35±2.39) weeks.Pleural effusion was bilateral in 13 cases, right-sided in seven cases, and left-sided in one case. Seven infants presented with fetal hydrops, and nine experienced birth asphyxia. The premature infants were 13 cases and the full-term infants were eight cases.The preterm group had a significantly higher rate of intrauterine therapy and lower serum albumin levels compared with the full-term group ( P<0.05). No significant differences were observed between the two groups in the use of mechanical ventilation, treatment modality, duration of pleural effusion, or length of hospital stay ( P>0.05). Of the 21 cases of CC,12 cases achieved resolution of pleural effusion after conservative treatment, which included thoracentesis, sequential nutritional therapy, and octreotide administration. Eight infants required additional chemical pleurodesis with intrathoracic erythromycin and subsequently recovered. Among all patients, 18 cases were discharged after improvement, and no recurrence was found after telephone follow-up for 8~12 months after birth.Three infants were diagnosed with Down syndrome,one died after early withdrawal of treatment, and the other two with pleural effusion disappeared after treatment were lost to follow-up after discharge. Conclusions:Preterm infants with CC are more likely to receive intrauterine therapy and have lower serum albumin levels than full-term infants. For patients who do not respond to conservative management, chemical pleurodesis with intrathoracic erythromycin can be considered. Most neonates with CC have a favorable prognosis after appropriate treatment.
