Thoracoscopic Pleurodesis in Management of Massive Chylothorax in Nephrotic Syndrome: A Case Report

利用視訊輔助胸腔鏡手術行肋膜沾粘術以治療因腎病症候群引起之乳糜胸：一病例報告

林致源(Chih-Yuan Lin) ； 林石化(Shih-Hua Lin) ； 陳仁智(Jen-Chih Chen) ； 李世俊(Shih-Chun Lee) ； 程永隆(Yeung-Leung Cheng)

《Journal of Medical Sciences》 20卷4期 (2000/02) Pp. 195-200

摘要

一位59歲男性在一個月前經診斷為腎病症候群，曾接受類固醇治療。此次入院前多天開始有呼吸急促、腹脹及全身水腫等症狀。住院時胸部X-光檢查發現右側肋膜積液合併縱隔腔左移現象。緊急胸管置放發現大量乳白色液體。經電泳分析證實為乳糜胸。腹水分析及核醫掃描檢查確定乳糜胸之成因乃為腎病症候群造成乳糜腹水及橫膈缺損引起。病患隨即接受視訊輔助胸腔鏡手術，以四環黴素行肋膜沾粘術，術後病患恢復良好，症狀明顯改善，經半年追蹤後無復發跡象。

關鍵字

視訊輔助胸腔鏡手術 ； 乳糜胸 ； 腎病症候群 ； 橫膈缺損

並列摘要

A 59-year-old male with nephritic syndrome admitted to our hospital due to intractable shortness of breath as a cause of recurrent massive hydrothorax. The chest X-ray examination showed marked pleural effusion over the fight lung field with leftward shift of the mediastinum. The left side of the chest was clear and ascites was noted. Chyloperitonum and chylothorax were verified through lipoprotein electrophoresis of fluids. A lung scan was performed using Tc-99m sulfur colloid injection to the peritoneal cavity and it revealed transdiaphragmatic communication of chylous ascites to the plural cavity. The patient was successfully managed by throacoscopic pleurodesis with tetracycline.

並列關鍵字

Video-assisted thoracic surgery (VATS) ； Chylothorax ； Nephrotic syndrome ； Diaphragmatic defect