中鏈甘油三酯在治療乳縻胸之應用

Median Chain Triglyceride Oil in the Treatment of Chylothorax-A Case Report

魏崢(J. Wei) ； 邱文達(W. T. Chiu) ； 金惠民(H. M. King)

《Journal of Medical Sciences》 4卷1期 (1981/07) Pp. 1157-1162

並列摘要

Chylothorax may be congenital or traumatic. The most common cause of traumatic chylothorax is iatrogenic, especially caused by thoracic and cardiovascular surgeries involving the great vessels. Nutritional loss is a major problem and is recognized as a cause of high mortality rate of chylothorax in the past.Although the leakage of chylus fluid may ceased spontaneously, care should be taken to correct the nutritional loss including fat, protein, electrolyte, and fluid. A major problem in doing this is the effect of fat on the production of lymph. Intake of fat will cause an increase of fluid in the thoracic duct and therefore exacerbates the chylus leakage in cases with chylothorax, which further delays the spontaneous healing of the fistula. Median chain triglyceride (MCT) oil is a kind of synthetic fat. It can be easily absorbed, by way of the portal venous system, from the gastrointestinal tract without stimulating the production of chylus fluid.A case of iatrogenic chylothorax was treated with MCT oil in Tri-service General Hospital. The pleural effusion decreased in its amount following NPO and parenteral nutrition. Diet with MCT oil as its only source of fat was prescribed since the 22nd postoperative day. The amount of pleural fluid was not increased. MCT diet was continued for another one month and no recurrence of chylothorax was noticed.From our experience, MCT oil is helpful in the management of chylothorax. Further evaluation may be necessary in making sure the usefulness of MCT oil in this disease.