Clinical Analysis Of 30 Newborns With Chylothorax And/or Chylous Ascites

Objective: To retrospectively analyze the clinical characteristics and prognostic factors of the neonates with chylothorax and chylous ascites.Methods:The clinical data of neonates with chylothorax(chylous ascites)admitted to the neonatology department of our hospital from January 2011 to December 2018 were collected and analyzed retrospectively.According to gestational age and outcome,they were divided into premature infant group and full-term infant group,survival group and death group.Compared the clinical data of the two groups of neonates,explore the clinical characteristics and outcomes,and provide reference for rational management.Results:Among the 30 cases,25 cases were diagnosed as congenital chylothorax(chylous ascites).The gestational age was 30-39 w,the birth weight was 1600-4770 g,the ratio of male to female was 4/1(20/5),and 15 cases(60%)of premature infants,10cases(40%)of full-term infants.In the preterm infant group,the gestational age was30-36 w,with an average of 33+2w,body weight was 1600-3670 g,with an average of2495.0±615.9g.There were 11 males,4 females,1 left pleural effusion,4 right pleural effusion,7 bilateral,3 chyloperitoneum and 4 pleural effusion.All cases survived in15 cases and died in 10 cases,with a mortality rate of 40.0%.10 full-term infants,gestational age 37-39 w,average 38 w,weight 2930-4770 g,average weight 3711.0g±529.5g,left pleural effusion in 1 case,right in 2 cases,bilateral in 6 cases,and chyloperitoneum in 1 case,all survived.The survival rate of full-term infants was significantly higher than that of premature infants.There were 15 survivors,10full-term infants(66.7%,10/15),5 premature infants(33.3%,5/15),average weight of3212.0±818.5g,and the proportion of patients requiring mechanical P ventilation treatment(7,46.7%)was significantly lower than that in death group(10,100%)(P =0.008).The mean plasma albumin(34.6±4.6g/L)in survival group was significantly higher than that in death group(23.6±7.4g/L)(P =0.002).Of the 5 neonates with secondary chylothorax,4 were premature infants after PICC catheterization.All of them were premature infants.One patient underwent arterial catheter ligation and recovered after treatment.Conclusion: Congenital chylothorax can be found prenatal,The mortality rate of preterm infants with chylothorax(chylous ascites)is higher,the survival rate of full-term infants is significantly higher than premature infants.The survival rate of those with large birth weight is high.In the death group,the proportion of mechanical ventilation was higher,and the plasma albumin level was lower than the survival group,suggesting that plasma albumin was excessively lost with the production of chyle.PICC catheterization can lead to secondary chylothorax.