中国口腔颌面外科杂志

中国口腔颌面外科杂志 ›› 2025, Vol. 23 ›› Issue (5): 425-433.doi: 10.19438/j.cjoms.2025.05.001

• 专家共识 • 上一篇    下一篇

口腔颌面部恶性肿瘤颈淋巴清扫术后乳糜漏临床营养管理专家共识

黄秋雨1,#, 王帅1,#, 何悦2, 郑家伟2, 彭歆3, 刘冰4, 李一5, 王安训6, 刘习强7, 陈传俊8, 毕小琴9, 杨悦3, 吴红梅10, 叶艳彬11, 肖炜12, 陈芸梅6, 赵芳7, 李燕娥13, 周陶14, 何杏芳1, 王澄15, 叶菁菁1, 王晓玲16, 陈超刚15,*, 侯劲松1,*   

  1. 1.中山大学附属口腔医院 口腔颌面外科,广东省口腔医学重点实验室,中山大学口腔医学研究所,广东 广州 510055;
    2.上海交通大学医学院附属第九人民医院 口腔颌面-头颈肿瘤科,上海 200011;
    3.北京大学口腔医院 口腔颌面外科,北京 100081;
    4.武汉大学口腔医院 口腔颌面头颈肿瘤外科,湖北 武汉 430079;
    5.重庆医科大学附属口腔医院 口腔颌面外科,重庆 401147;
    6.中山大学附属第一医院 口腔颌面外科,广东 广州 510080;
    7.南方医科大学南方医院 口腔科,广东 广州 510515;
    8.中国科学技术大学附属第一医院 口腔颌面外科,安徽 合肥 230001;
    9.四川大学华西口腔医院 头颈肿瘤外科,四川 成都 610041;
    10.南京医科大学附属口腔医院 护理部,江苏 南京 210029;
    11.暨南大学附属第一医院 临床营养科,广东 广州 510630;
    12.广州医科大学口腔医学院·附属口腔医院 护理部,广东 广州 510140;
    13.南方医科大学附属广东省人民医院（广东省医学科学院） 口腔颌面外科,广东 广州 510080;
    14.北京大学深圳医院 口腔颌面外科,广东 深圳 518036;
    15.中山大学孙逸仙纪念医院 临床营养科,广东 广州 510120;
    16.中山大学附属第八医院 临床营养科,广东 深圳 518033
  • 收稿日期:2025-02-12 修回日期:2025-03-25 发布日期:2025-10-10
  • 通讯作者: 侯劲松,E-mail: houjs@mail.sysu.edu.cn;陈超刚,E-mail: chenchg@mail.sysu.edu.cn。*共同通信作者
  • 作者简介:黄秋雨（1978-）,女,副主任护师,E-mail: hqyu@mail.sysu.edu.cn;王帅（1993-）,男,主管护师,E-mail: wangsh58@mail.sysu.edu.cn。#并列第一作者
  • 基金资助:
    广东省医学科研基金项目（A2021008）; 中山大学临床医学研究5010项目（2015018）; 广东省岭南南丁格尔护理研究院、广东省护理学会护理创新发展研究课题（GDHLYJYB202418）

Expert consensus on clinical nutrition management of chyle leakage in neck dissection of patients with oral and maxillofacial malignant tumors

Huang Qiuyu1, Wang Shuai1, He Yue2, Zheng Jiawei2, Peng Xin3, Liu Bing4, Li Yi5, Wang Anxun6, Liu Xiqiang7, Chen Chuanjun8, Bi Xiaoqin9, Yang Yue3, Wu Hongmei10, Ye Yanbin11, Xiao Wei12, Chen Yunmei6, Zhao Fang7, Li Yan'e13, Zhou Tao14, He Xingfang1, Wang Cheng15, Ye Jingjing1, Wang Xiaoling16, Chen Chaogang15, Hou Jinsong1   

  1. 1. Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, Sun Yat-sen University; Guangdong Provincial Key Laboratory of Stomatology; Institute of Stomatology, Sun Yat-sen University. Guangzhou 510055, Guangdong Province;
    2. Department of Oromaxillofacial Head and Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine. Shanghai 200011;
    3. Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Peking University. Beijing 100081;
    4. Department of Oral and Maxillofacial Head and Neck Oncology, School and Hospital of Stomatology, Wuhan University. Wuhan 430079, Hubei Province;
    5. Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, Chongqing Medical University. Chongqing 401147;
    6. Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Sun Yat-sen University. Guangzhou 510080, Guangdong Province;
    7. Department of Stomatology, Nanfang Hospital, Southern Medical University. Guangzhou 510515, Guangdong Province;
    8. Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of University of Science and Technology of China. Hefei 230001, Anhui Province;
    9. Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University. Chengdu 610041, Sichuan Province;
    10. Department of Nursing, Stomatological Hospital Affiliated to Nanjing Medical University. Nanjing 210029, Jiangsu Province;
    11. Department of Clinical Nutrition, the First Affiliated Hospital of Jinan University. Guangzhou 510630, Guangdong Province;
    12. Department of Nursing, School and Hospital of Stomatology, Guangzhou Medical University. Guangzhou 510140, Guangdong Province;
    13. Department of Oral and Maxillofacial Surgery, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University. Guangzhou 510080, Guangdong Province;
    14. Department of Oral and Maxillofacial Surgery, Peking University Shenzhen Hospital. Shenzhen 518036, Guangdong Province;
    15. Department of Clinical Nutrition, Sun Yat-sen Memorial Hospital, Sun Yat-sen University. Guangzhou 510120, Guangdong Province;
    16. Department of Clinical Nutrition, The Eighth Affiliated Hospital, Sun Yat-sen University. Shenzhen 518033, Guangdong Province, China
  • Received:2025-02-12 Revised:2025-03-25 Published:2025-10-10

PDF (PC)

59

摘要： 乳糜漏治疗以保守治疗为主,临床营养管理是保守治疗的主要内容,对乳糜漏患者的快速康复至关重要。目前不同医疗单位对口腔颌面部恶性肿瘤颈淋巴清扫术后乳糜漏临床营养管理措施各不相同,尚缺乏广为认可的、标准化的管理流程。为规范口腔颌面部恶性肿瘤颈淋巴清扫术后乳糜漏临床营养管理模式,促进快速康复,改善健康结局,本团队基于现有最新文献证据,汇集全国21家医学院校及相关医院多学科专家意见,采用德尔菲法并经专家会议反复讨论,制定出口腔颌面部恶性肿瘤颈淋巴清扫术后乳糜漏临床营养管理专家共识。本共识除重点介绍临床营养管理外,还对乳糜漏的发生、术中预防、乳糜漏诊断、并发症监测、常规保守治疗及手术治疗方案等进行了介绍。

关键词: 口腔颌面部肿瘤, 颈淋巴清扫术, 乳糜漏, 营养管理, 保守治疗, 专家共识

Abstract: The treatment of chyle leakage primarily relies on conservative approaches, with clinical nutrition management being a crucial component that significantly contributes to the rapid recovery of chyle leakage patients. Currently, the clinical nutrition management strategies for chyle leakage following neck dissection in patients with oral and maxillofacial malignant tumors vary across different medical institutions, and there is a lack of widely accepted and standardized management procedures. To standardize the clinical nutrition management of chyle leakage after neck dissection in patients with oral and maxillofacial malignant tumors, promote rapid recovery, and improve health outcomes, our team developed the expert consensus on clinical nutrition management of chyle leakage in neck dissection of patients with oral and maxillofacial malignant tumors. The consensus was developed based on the best available literature and the collective opinions of multidisciplinary experts from 21 medical colleges and affiliated hospitals in China. The consensus not only focused on clinical nutrition management, but also provided essential information on the etiology of chyle leakage. Additionally, it covered intraoperative prevention, diagnosis, monitoring of complications, conventional conservative treatment, and surgical treatment as necessary.

Key words: Oral and maxillofacial tumor, Neck dissection, Chyle leakage, Nutrition management, Conservative treatments, Expert consensus

中图分类号: