Etiology of chylothorax in 203 patients
Etiology of chylothorax in 203 patients
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DOI：
10.4065/80.7.867
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发表时间：
2005-07-01
影响因子：
8.9
通讯作者：
Ryu, JH
中科院分区：
文献类型：
--
作者：
Doerr, CH;Allen, MS;Ryu, JH
目的：描述在一个三级转诊中心遇到的乳糜胸患者的病因，并将其结果与以前的研究结果进行比较。从1980年1月1日至2000年12月31日，在明尼苏达州罗切斯特的马约诊所就诊的所有乳糜胸患者的病历，结果：我们确定了203例乳糜胸患者，其中92例为女性（男女比例为1.21）。中位年龄为54.5岁（范围：妊娠21周至93岁）。在173例有首发症状的患者中，98例（56.6%）出现呼吸困难，而64例（37.0%）无呼吸道症状。诊断前症状的中位持续时间为7.5周（范围：1天至4.5年）。乳糜胸的原因包括101例（49.8%）手术或创伤，89例（43.8%）各种医疗条件，13例（6.4%）未知。在外科手术中，食管切除术（29例患者）和先天性心脏病手术（28例患者）是乳糜胸最常见的原因。在医疗条件，淋巴瘤（23例），淋巴系统疾病（19例）和乳糜腹水（16例）是最常见的原因。与以往的研究不同，手术或创伤是我们机构乳糜胸最常见的原因，占病例的近50%。淋巴瘤和其他恶性肿瘤引起乳糜胸仅占16.7%。这些数字可能与我们的三级转诊中心进行的大量心胸外科手术有关。
OBJECTIVES: To characterize the etiology of chylothorax in patients encountered at a single tertiary referral center and to compare the findings with those from previous studies.PATIENTS AND METHODS: The medical records of all patients with chylothorax seen at the Mayo Clinic in Rochester, Minn, over a 21-year period, from January 1, 1980, to December 31, 2000, were retrospectively reviewed to ascertain the underlying cause of their condition.RESULTS: We identified 203 patients with chylothorax; 92 were females (male-female ratio, 1.21). The median age was 54.5 years (range, 21 weeks' gestation to 93 years). Dyspnea, the most common presenting symptom, occurred in 98 (56.6%) of 173 patients in whom initial symptoms were recorded, whereas 64 (37.0%) had no respiratory symptoms. Median duration of symptoms before diagnosis was 7.5 weeks (range, 1 day to 4.5 years). Causes of chylothorax included surgery or trauma in 101 patients (49.8%), various medical conditions In 89 (43.8%), and unknown in 13 (6.4%). Among surgical procedures, esophagectomy (29 patients) and surgery for congenital heart disease (28 patients) were the most common causes of chylothorax. Among medical conditions, lymphoma (23 patients), lymphatic disorders (19 patients), and chylous ascites (16 patients) were the most common causes.CONCLUSIONS: Chylothorax has numerous causes. In contrast to previous studies, surgery or trauma was the most common cause of chylothorax at our Institution, accounting for nearly 50% of cases. Lymphoma and other malignancies caused chylothorax In only 16.7% of cases. These numbers are possibly related to the high volume of cardiothoracic surgical procedures performed at our tertiary referral center.