PDF(Pubmed)
Abstract：
The purpose of this retrospective study was to evaluate the occurrence of infectious complications and inflammatory reactions after transabdominal lymphatic-interventions. 63 lymphatic-interventions were performed in 60 patients (male/female: 35/25; mean age 56 [9-85] years) [chylothorax n = 48, chylous ascites n = 7, combined chylothorax/chylous ascites n = 5]. Post-interventional clinical course and laboratory findings were analyzed in the whole cohort as well as subgroups without (group A; n = 35) and with peri-interventional antibiotics (group B; n = 25) (pneumonia n = 16, drainage-catheter inflammation n = 5, colitis n = 1, cystitis n = 1, transcolonic-access n = 2). No septic complications associated with the intervention occurred. Leucocytes increased significantly, peaking on post-interventional day-1 (8.6 ± 3.9 × 106 cells/mL vs. 9.8 ± 4.7 × 106 cells/mL; p = 0.009) and decreased thereafter (day-10: 7.3 ± 2.7 × 106 cells/mL, p = 0.005). CRP-values were pathological in 89.5% of patients already at baseline (40.1 ± 63.9 mg/L) and increased significant on day-3 (77.0 ± 78.8 mg/L, p < 0.001). Values decreased thereafter (day-15: 25.3 ± 34.4 mg/L, p = 0.04). In subgroup B, 13/25 patients had febrile episodes post-interventionally (pneumonia n = 11, cystitis n = 1, drainage-catheter inflammation n = 1). One patient developed biliary peritonitis despite continued antibiotics and underwent cholecystectomy. Baseline leucocytes and CRP-levels were higher in group B than A, but with comparable post-interventional profiles. Clinically relevant infectious complications associated with transabdominal lymphatic-interventions are rare irrespective of peri-interventional antibiotic use. Post-interventional elevation of leucocytes and CRP are observed with normalization over 10-15 days.
摘要：
这项回顾性研究的目的是评估经腹淋巴干预后感染并发症和炎症反应的发生。60例患者（男/女：35/25；平均年龄56[9-85]岁）进行了63次淋巴干预[乳糜胸n=48，乳糜腹水n=7，乳糜胸/乳糜腹水合并n=5]。分析了整个队列以及无（A组；n=35）和使用围介入抗生素（B组；n=25）的亚组（肺炎n=16，引流导管炎症n=5，结肠炎n=1，膀胱炎n=1，经结肠通道n=2）的介入后临床病程和实验室检查结果。未发生与干预相关的脓毒症并发症。白细胞显著增加，在介入后第1天达到峰值（8.6±3.9×106个细胞/mL与9.8±4.7×106个细胞/mL；p=0.009），此后降低（第10天：7.3±2.7×106个细胞/mL，p=0.005)。CRP值在基线时已经有89.5%的患者出现病理（40.1±63.9mg/L），在第3天显著增加（77.0±78.8mg/L，p<0.001)。此后值下降（第15天：25.3±34.4mg/L，p=0.04)。在B亚组中，13/25患者在干预后出现发热发作（肺炎n=11，膀胱炎n=1，引流导管炎症n=1）。尽管继续使用抗生素，一名患者仍出现胆源性腹膜炎，并接受了胆囊切除术。B组基线白细胞和CRP水平高于A组,但具有可比的介入后资料。与经腹淋巴干预相关的临床相关感染并发症很少见，而与围介入抗生素的使用无关。观察到干预后白细胞和CRP的升高，并在10-15天内恢复正常。
