Congenital idiopathic chylothorax in neonates: chemical pleurodesis with povidone-iodine (Betadine)
Congenital idiopathic chylothorax in neonates: chemical pleurodesis with povidone-iodine (Betadine)
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DOI：
10.1136/fn.88.6.f531
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发表时间：
2003-11-01
影响因子：
4.4
通讯作者：
Demarquez, JL
中科院分区：
文献类型：
--
作者：
Brissaud, O;Desfrere, L;Demarquez, JL
乳糜胸是指乳糜在胸膜腔内的积聚。这种情况通常发生在手术后，先天性特发性形式是罕见的（1/15000出生）。在大多数情况下，在诊断后四至六周内观察到恢复。治疗方法可以是保守治疗或手术治疗。报告了4例先天性乳糜胸（3例特发性，1例伴有弥漫性淋巴管扩张），采用化学胸膜固定术（胸膜内注射聚维酮碘）进行治疗。耐受性令人满意：在探索的3例病例中，甲状腺功能未改变; 1例一过性全身水肿。在4例病例中，有3例被认为治疗成功。1名儿童死于肾衰竭（与化学胸膜固定术无关）。聚维酮碘胸膜固定术似乎耐受性良好，可能是先天性特发性乳糜胸机械磨损或手术的良好替代方案。它用于顽固性乳糜胸也可能降低与住院时间延长相关的发病率。
Chylothorax is defined as an accumulation of chyle in the pleural space. This condition usually occurs after an operation, the congenital idiopathic form being rare (1/15000 births). Recovery is observed within four to six weeks of diagnosis in most cases. Treatment is either conservative or surgical. Four cases are reported of congenital chylothorax (three idiopathic, one accompanied by diffuse lymphangectasia) managed by chemical pleurodesis (intrapleural injection of povidone-iodine). Tolerance was satisfactory: unaltered thyroid function in the three cases explored; one case of transient generalised oedema. Treatment was deemed successful in three of the four cases. One child died from renal failure (unrelated to the chemical pleurodesis). Pleurodesis by povidone-iodine appears to be well tolerated and may represent a good alternative to mechanical abrasion or surgery for congenital idiopathic chylothorax. Its use for refractory chylothorax may also decrease the morbidity related to prolonged hospital stay.