Abstract:

Chylous hydrothorax is a relatively rare cause of pleural effusion in children. The common reason is primary lymphatic diseases such as congenital chylothorax and lymphangiomatosis，which have a high death rate. Conservative treatment is important including alimentary control，such as a fat-free diet with the addition of medium-chain triglycerides and total parenteral nutrition，somatostatin and octreotide，which reduce lymphatic fluid production and lymphatic flow. Surgical treatment is recommended，such as ligation of thoracic duct and pleurodes，when conservative treatment fails.

Key words: chylothorax, chylous hydrothorax, diagnosis, treatment

摘要：

乳糜性胸腔积液较少见，在儿童常见原因为原发于淋巴系统的疾病，如先天性乳糜胸、淋巴管瘤病等，治疗难度大，病死率高。保守治疗包括饮食控制（食用中链脂肪酸或全胃肠外营养支持）、生长抑素或奥曲肽减少淋巴液生成及流动；对诊断技术需要开展精细的发掘；外科治疗方面，胸导管结扎术适用于多数继发性乳糜胸，胸膜粘连术安全有效。原发性乳糜胸的发生意味着淋巴回流的代偿受限和失代偿，治疗方向是改善淋巴回流基础上的综合治疗。

关键词: 乳糜胸, 乳糜性胸腔积液, 诊断, 治疗