JR Pan, LP Shi, MY Sun

Abstract

We described the treatment and therapeutic effect of chemical pleurodesis with erythromycin for the three refractory neonates. Chylothorax is a comparatively rare disease with an incidence ranging from 1 in 6000 to 1 in 10000 and a male to female predominance (2:1). Underlying cause is usually attributable to 1 of 4 categories: malignancy, trauma (including surgery), miscellaneous disorders, and idiopathic. We described three neonates who suffered from idiopathic congenital chylothorax. Although rare, congenital idiopathic chylothorax is the most common form of pleural effusion in neonates. Significant long-term morbidity and mortality were reported because of immunologic, metabolic, and nutritional complications in neonates. Many forms of conservative therapy are not always effective in treating idiopathic congenital chylothorax. In our three reported cases, conservative therapy including the provision of total parenteral nutrition and repeated drainage of pleural effusion failed. Eventually all the cases were successfully treated by chemical pleurodesis with erythromycin.

本文報導應用紅霉素化學胸膜固定術，治療三例難治性新生兒特發性先天性乳糜胸病例的方法以及療效。乳糜胸是一種相對罕見疾病，發病率六千分之一至萬分之一，男女發病比例約二比一，其病因常分為四類：惡性、損傷性、混合性和特發性。該病雖然罕見，但其為新生兒胸腔積液中最常見的發病形式。乳糜胸引發新生兒免疫、代謝、營養途徑異常而致病，重者導致死亡。許多保守治療方法在救治部分新生兒特發性先天性乳糜胸中效果不佳。對於本文報導的三例患兒，應用包括全腸道外營養和反復穿刺引流的保守治療失敗。最終，該三例患兒應用紅霉素化學胸膜固定術治療成功。