Non-invasive Management of Chylothorax Secondary to Liver Cirrhosis-Report of a Case

肝硬化併發乳糜胸的非侵入性治療

林昌生(Chang-Sheng Lin) ； 謝孟哲(Meng-Jer Hsieh) ； 蔡熒煌(Ying-Huang Tsai)

《胸腔醫學》 23卷2期 (2008/04) Pp. 125-131

https://doi.org/10.29806/TM.200804.0008

摘要

乳糜胸是肋膜腔內聚積乳狀淋巴液的一種罕見疾病，常見的致病因有腫瘤、外傷及其他未知或少見的因素。肝硬化被歸類為罕見的病因之一，並有較差的預後，病患常因營養不良或免疫力差而死亡。本篇病例報告敘述一位乳糜胸的患者，最初以呼吸困難和水腫來表現，經進一步檢查得知肝硬化是其致病因。一般而言，肝硬化併發乳糜胸通常是難以處理且預後不佳。以往，有許多侵入性或昂貴的治療曾被提出，但未曾有過以非侵入性方式成功治療肝硬化併發乳糜胸的病例。此病患成功地以利尿劑治療且合併低鈉飲食的控制下，經一年的追蹤，乳糜胸並未再發生。

關鍵字

乳糜胸 ； 肋膜積水 ； 胸管 ； 三甘油脂

並列摘要

Chylothorax is a rare event that occurs when milk-like lymphatic fluid accumulates in the pleural space. The common causes of chylothorax are tumors, trauma, or other unknown etiologies. Liver cirrhosis has been classified as one of the uncommon etiologies of chylothorax with a worse prognosis than other etiologies. Patients often die from malnutrition or an immunocompromised status. This report describes a patient who suffered from chylothorax with initial presentations of dyspnea and generalized edema. After a series of work-ups, decompensated liver cirrhosis was found to be the only possible etiology. Generally, chylothorax secondary to liver cirrhosis is hard to manage and the prognosis is poor. Many invasive or expensive therapies have been introduced to manage chylothorax secondary to liver cirrhosis, but successful management with noninvasive conservative therapy has not been reported. Our patient was successfully treated with diuretics, and the chylothorax did not recur during the following 12 months under a sodium-restricted diet.

並列關鍵字

chylothorax ； pleural effusion ； thoracic duct ； triglyceride