Clinical feature and outcomes analysis in 25 cases of newborns with congenital chylothorax and chyloperitoneum / 国际儿科学杂志

ABSTRACT

Objective:To investigate the clinical features and outcome of congenital chylothorax and chyloperitoneum ascites in infants.Methods:The clinical data of infants admitted to the Neonatal Department of Shengjing Hospital of China Medical University and diagnosed with congenital chylothorax and chyloperitoneum from January 2011 to December 2018 were analyzed retrospectively.According to outcome, the infants were assigned into survival group and death group.The clinical characteristics between the two groups were compared.Results:The total cases were 25(the ratio of male to female is 3.2). The gestational age ranged from 30 to 39 weeks, and the birth weight was 1 620 to 4 770 g. There were twenty infants were diagnosed before delivery accounted for 80%.Five infants(20%)presented with fetal edema.There were twenty-one infants were diagnosed with congenital chylothorax(84.0%, 5 with chyloperitoneum). Fourteen cases of congenital chylothorax were bilateral(66.7%), seven infants were unilateral, six infants(85.7%)were right-sided chylothorax.There four infants(16.0%)were diagnosed with chyloperitoneum.There were fifteen cases in the survival group, including eleven cases of chylothorax(73.3%), three cases of chyloperitoneum(20.0%), and one case of chylothorax combined with chyloperitoneum(6.7%). There were ten cases in the death group, all of which were premature infants, including nine cases of chylothorax and seven cases of bilateral chylothorax(70.0%). The median gestational age(33w)and birth weight(2 486 g)of the death group was significantly lower than the survival group(38w and 3 342 g), and the median gestational age when prenatal diagnosis[(30±1)weeks]was significantly lower than the survival group[(34±1)weeks]. The difference between the two groups was statistically significant( P<0.05). The proportion of mechanical ventilation in the death group was significantly higher than the survival group( P<0.05). Conclusion:The gestational age, birth weight, and the time of intrauterine diagnosis affect the outcome of congenital chylothorax and chyloperitoneum.The mortality rate is higher in premature, lower gestational age at the time of intrauterine diagnosis and bilateral chylothorax.