标题：以非乳白色胸腔积液为首发表现的双侧结核性乳糜胸一例

      作者：管媛 1，张程 2    1.贵州医科大学，贵州 贵阳 550001；2.贵州省人民医院呼吸与危重症医学科，贵州 贵阳 550001

      卷次： 2023年34卷2期

      【摘要】 一例45岁男性患者以“胸腔积液原因待查”收入院，胸腔穿刺引流后胸水由黄色脓性转变为乳白色后又转变为淡黄色，完善检查最终诊断为结核性乳糜胸。予抗结核、暂禁食、引流胸水及肠外营养支持等治疗后患者症状缓解，定期随访病情稳定。本病例警示临床医师对于结核性胸腔积液的鉴别诊断，需考虑同时存在乳糜胸，应进一步完善乳糜实验。
      【关键词】 乳糜胸；胸腔积液；结核；诊断；治疗
      【中图分类号】 R655 【文献标识码】 D 【文章编号】 1003—6350（2023）02—0272—03

A case report of bilateral tuberculous chylothorax with non-opalescent pleural effusion as the first presentation.GUAN Yuan 1, ZHANG Cheng 2.
1. Guizhou Medcial University, Guiyang 550001, Guizhou, CHINA; 2. Department ofRespiratory and Critical Care Medicine, Guizhou Provincial People's Hospital, Guiyang 550001, Guizhou, CHINA【Abstract】 A 45-year-old male patient was admitted to the hospital with "the cause of pleural effusion (to be ex-plored)", and the pleural effusion transformed from yellow purulent to milky white to light yellow after thoracentesis anddrainage. The diagnosis of tuberculous chylothorax was finally considered following the examinations. The patient'ssymptoms relieved after treatments such as anti-tuberculosis, temporary fasting, drainage of pleural fluid, and parenteralnutritional support, and the disease was stable during regular follow-up. This case warns clinicians that the differential di-agnosis of tuberculous pleural effusion should consider the simultaneous presence of chylothorax, and the further explo-ration of chylothorax test should be performed.
      【Key words】 Chylothorax; Pleural effusion; Tuberculosis; Diagnosis; Treatment　　　　　 ·个案报道·doi:10.3969/j.issn.1003-6350.2023.02.028基金项目：中国医学科学院中央级公益性科研院所基本科研业务费项目(编号：2019PT320003)。第一作者：管媛(1996—)，女，住院医师，主要研究方向为呼吸内科疾病研究。