胸导管介入综合治疗淋巴道转移癌的实验研究

目的　探讨经胸和颈三角区胸导管介入治疗淋巴道转移癌的可行性。方法　 10只试验犬经胸和颈三角区 ,通过 3种不同径路实施胸导管插管 ,长期保留 ,进行胸导管介入性实验研究。结果　胸导管插管可安全通畅地保留 2～ 3个月 ,没有乳糜胸或其他严重并发症 ;淋巴引流液经处理后无菌低温保存 1周后 ,可安全静脉回输 ;检测发现淋巴液中α1 、β、γ球蛋白含量高于正常值 ,甘油三酯高于正常值 ,但IgG、IgM、IgA等免疫球蛋白的含量较低 ;注射造影剂 10min后仍有大量造影剂滞留于淋巴道 ;胸导管介入较大剂量化疗药物观察 ,全身反应轻 ,3d后逐渐恢复正常。结论　经胸和颈三角区胸导管介入化疗药物防治淋巴道转移癌 ,有置管时间长、定期监测方便、局部药物浓度高、维持时间长、全身反应小等优点 ,提示用于临床是完全可行和安全的

An experimental study of treating lymphatic metastasis by the intervention of thoracic duct

Objective To study the interposition feasibility of a thoracic duct intervention in treating lymphatic metastasis. Methods A catheter was put into the thoracic duct in each of ten dogs in three different surgical pathways. The catheter was kept after the surgery in order to make the following observation possible.Results The thoracic duct catheteration could be stably observed for 2～3 months after the surgery without any complications. The collected lymph from it could also be safely reinjected back after the biochemical investigations, which showed a higher level of albumin α 1,β,γ, and the TG, a lower level of IgG, IgM, IgA than that in blood. The chemotherapy could be performed through this catheter, which was confirmed by thoracicography.Conclusion The thoracic duct intervention makes the lymph collection and investigation of its ingredients possible. The treated collected lymph can be safely reinjected back without complications. The chemotherapy through it has longer active period, greater accuracy and safety.