杨宁介入医学网

非创伤性乳糜漏病因 Non traumatic chyle leak Idiopathic Inflammation Lymphoma Waldenstrom disease Lymphangioleiomyomatosis Noonan disease Gorham disease Behcet disease 一组相关发病率报告，大多数是不明原因的 Idiopathic (n=14; 56%) Hematologi...

Ernest Starling (1894) 首次阐述肝淋巴流 E. Starling, The Influence of Mechanical Factors on Lymph Production, The Journal of Physiology, 1984 正常肝淋巴贡献胸导管30%-40%淋巴流 Normal liver lymph contributes 30-40% of the flow to the TD 每...

塑型支气管炎（Plastic Bronchitis PB)） Formation of large gelatinous or rigid branching airway casts 胸导管注射美兰 PB-TD injection with MB Itkin et al, Annals of American Thoracic Society 2016 Embolization-Lipiodol 术前 术后 成人塑型支气...

先天性淋巴管发育不良（Congenital lymphodysplasia）导致肺灌注综合征是新生儿疾病，表现为出生时全弥漫性水肿 先天性淋巴管发育不良胸导管外引流 Thoracic Duct Externalization for Congenital Lymphodysplasia Pulmonary Lymphatic Perfusion Syndrome (...

病例一 1岁 男性，淋巴瘤患者，乳糜胸引流数月，总共引流＞50升，引流管已经感染. 左侧胸水 超声引导下淋巴结穿刺 淋巴结穿刺淋巴造影 淋巴盆腔瘘 造影进入盆腔 直接淋巴管穿刺造影 对侧经淋巴结淋巴造影，造影剂外溢 漏来自双侧淋巴管，和多发异常淋巴管，...

并发症 Complications 经皮穿刺和栓塞引起的主观疼痛通常在24小时内自发解决 碘油和NBCA外溢似乎并不是问题 Extravasation of oil and glue does not seem like an issue 没有有关腹部入路相关并发症，但应考虑潜在并发症，如出血等 注射时，胶通过淋巴静脉...

经淋巴结穿刺淋巴造影 Intranodal lymphangiography 优点 穿刺时间短 技术简单 碘油通过快 超声引导下，23G或更细的针穿刺入淋巴结。针连接延长管和1-2.5ml注射器，缓慢注射碘油...

碘油淋巴造影 Oil-based lymphangiography 实施淋巴介入寻求保守及外科治疗以外更为安全有效的方法。首先需要淋巴造影 自从经腹股沟淋巴结注射淋巴造影问世后，由于技术简单，实施病例不断增加Increasingly performed after introduction of inguinal intran...

淋巴造影技术 Lymphangiography technique Intranodal lymphangiography by injecting Lipiodol through a 25-gauge needle Real-time fluoroscopy to detect extravasation of Lipiodol from the lymphatic system Leak negative: no further procedure Lea...

淋巴结胶注射/栓塞治疗乳糜腹水和淋巴囊肿 Lymph Node Glue Injection/Embolization for Chylous Ascites and Lymphoceles 腹腔腹水和淋巴囊肿发生于淋巴渗漏，这往往是医源性的 Chylous ascites and lymphoceles occur from lymphatic leakage, which is oft...