| Background:Chylous pleural effusion is a rare disease in clinic.With the improvement of medical diagnosis and treatment,the consultation rate of patients also increases.However,there are no recognized guidelines for the treatment of chylous pleural effusion,and there is a lack of in-depth understanding of the factors affecting the occurrence,treatment and prognosis of chylous pleural effusion.Objective:In order to deepen the understanding of chylous pleural effusion diseases,this study selected patients with chylous pleural effusion who were hospitalized in Second Xiangya Hospital of Central South University in recent 11 years.To analyze and summarize the demographic characteristics,clinical features,therapeutic effect and related factors affecting prognosis of patients with chylous pleural effusion.The aim is to deepen the understanding of the clinical characteristics of chylous pleural effusion and improve the level of diagnosis and treatment.Methods:From January 2010 to May 2021,45 patients with chylous pleural effusion were admitted to Second Xiangya Hospital of Central South University.45 patients were divided into the simple conservative treatment group and the conservative and surgical group according to whether they received surgical treatment during hospitalization.The operative method for all surgical patients is ligation of thoracic duct(TDL).The hospitalization time,hospitalization cost and treatment efficiency of the two groups were analyzed and compared.30 patients who were followed up for 1 year were divided into the conservative treatment group and the surgical group according to whether they received surgical treatment during hospitalization and follow-up.The operative method for all surgical patients is ligation of thoracic duct(TDL).The effective rate and recurrence rate of the two groups were analyzed and compared.The conservative treatment of non-invasive venereal disease patients were divided into non-tumor etiology group and tumor etiology group.The hospitalization time,hospitalization cost,treatment effective rate and recurrence rate were analyzed and compared between the two groups.Univariate correlation analysis was carried out between hospitalization time and previous disease history,lung disease and treatment plan.Results: Among the 45 patients with chylous pleural effusion,there were 38 patients in the simple conservative treatment group(84.4%)and7 patients in the conservative and surgical treatment group(15.6%).The effective rate of the simple conservative treatment group was 63.2%,and that of the conservative and surgical treatment group was 100%.The difference was statistically significant(p=0.04).The hospitalization cost was 17591.7 ±13007.8 yuan in the simple conservative treatment group and 48870.1 ±22457.2 yuan in the conservative and surgical treatment group.The difference was statistically significant(p=0.002).The length of hospital stay was 13.9 ±8.4 days in the simple conservative treatment group and 22.1 ±17.2 days in the conservative and surgical treatment group.The difference was not statistically significant(p=0.26).Among the 30 patients who were followed up for 1 year,there were 18 cases(60.0%)in conservative treatment group and 12 cases(40.0%,7 cases were operated in our hospital,5 cases were operated in other hospitals during follow-up)in operation group.The effective rate of conservative treatment group was 72.2%,and that of surgical treatment group was100%.The difference between the two groups was statistically significant(p=0.02).The recurrence rate was 38.9% in the conservative treatment group and 25.0% in the surgical treatment group.The difference between the two groups was statistically significant(p=0.01).Conservative treatment of 31 patients with non-invasive venereal diseases 25 cases(80.6%)in the non-tumor etiology group and 6 cases(19.4%)in the tumor etiology group.The treatment effective rate of non-tumor etiology group was 76.0%,and that of tumor etiology group was 50.0%.The difference was statistically significant(p=0.02).The recurrence rate was53.3% in the non-tumor group and 50.0% in the tumor group.The difference was not statistically significant(p=1.00).The hospitalization time was 13.3 ±8.1 days in the non-tumor cause group and 16.5 ±9.7 days in the tumor cause group.The difference was not statistically significant(p=0.36).The hospitalization cost was 15912.4 ±10978.8 yuan in the non-tumor cause group and 22659.6 ±11212.4 yuan in the tumor cause group.The difference was not statistically significant(p = 0.16).Univariate analysis of hospitalization time and clinical factors in 45 patients with chylous pleural effusion showed that pulmonary disease(p=0.03),total parenteral nutrition(p=0.04)and low fat diet(p=0.04)had influence on hospital stay.Diabetes(p=0.54),hypertension(p=0.54)and history of thoracic surgery(p=0.38)were not related to the length of stay.Conclusions:1.The effect of surgical treatment of patients with chylous pleural effusion is better than that of conservative treatment,and surgical treatment can reduce the recurrence rate of chylous pleural effusion.2.The conservative treatment effect of non-tumor patients with chylous pleural effusion is better than that of patients with tumor causes.3.The length of stay of patients with chylous pleural effusion is related to lung disease,total parenteral nutrition and low-fat diet. |
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