乳糜性胸腔积液
1定义
乳糜性胸腔积液：乳糜渗入胸膜腔所致，病因为胸导管或其分支梗阻或损伤、或乳糜由腹腔经膈肌流入胸腔；外观通常是乳白色的，其特征是甘油三酯升高mg/dL或存在乳糜微粒。
假性乳糜胸，也称为胆固醇积液和乳糜样积液，其富含胆固醇，与慢性炎症性疾病有关。假性乳糜胸的临床定义是乳白色胸腔积液，胆固醇水平大于mg/dL，甘油三酯水平通常低于mg/dL，胸膜胆固醇/甘油三酯比大于1，以及显微镜下常可见胆固醇结晶。
2病因
Lymphangioleiomyomatosis
3诊断
1）胸腔积液化验
triglyceridesaremg/dLandtheclinicalhistoryorpleuraleffusionappear-anceareconsistentwithapossibleetiologyofchylothorax,thenapleuralchylomicronstudycanbeperformed.Thepresenceofpleuralchylomicronsconfirmsthediagnosisofachylothorax,andtheirab-sencesuggestsanalternativeetiology
lymphocyte-predominantprotein-discordantexudate
2）胸腹盆CT、Lymphangiography、lymphoscintigraphy、magneticresonance(MR)lymphangiography
4治疗
thoracicductligation(TDL),thoracicductembolizationordisruption(TDE/TDD),andmedicalorsurgicalpleurodesis
参考文献：
1RileyLE,AtayaA.Clinicalapproachandreviewofcausesofachylothorax.RespirMed.Oct;:7-13.doi:10./j.rmed..08..EpubAug22.Review.PubMedPMID:.
2Liu,M.,etal.(2)."Surgicaltreatmentofchylothoraxcausedbylymphangioleiomyomatosis."JournalofThoracicDisease6(2):E11-14.
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