妊娠期乳糜尿临床诊疗思维

Clinical Diagnosis and Treatment Thinking of Chyluria during Pregnancy

摘要: 乳糜尿即尿液中混有淋巴液或乳糜，外观多呈乳白色。发病年龄以中年居多，常在有过流行病区旅居史、高脂饮食、劳累受凉、重体力劳动后发病，多呈间歇性出现。因乳糜尿患者体内大量丢失蛋白质及脂肪，造成不同程度营养不良，病程较长者还会出现贫血、全身免疫力下降等症状，影响患者健康。而女性妊娠后各脏器负荷加重、免疫力下降，处于特殊时期，治疗的方案和时机选择有限，临床管理中要考虑的因素更多，挑战更大。本文通过总结归纳乳糜尿的发病机制、临床表现、诊治方法等，提高临床医生对本病的认识，降低漏诊、误诊率，为妊娠期乳糜尿患者的临床管理提供依据。

Abstract: Chyluria is urine mixed with lymph fluid or chyle, the appearance is mostly milky white. The age of onset is mostly middle age, often in the history of travel to epidemic areas, high-fat diet, fatigue and cold, heavy physical work after the onset, mostly intermittent. Because chyluria patients lose a lot of protein and fat in the body, resulting in different degrees of malnutrition, the course of the elderly will also appear anemia, systemic immunity decline and other symptoms, affecting the health of pa-tients. After pregnancy, the load of various organs is increased, and the immunity is decreased. In the special period, the treatment plan and opportunity are limited, and there are more factors to consider and greater challenges in clinical management. By summarizing the pathogenesis, clinical manifestations, diagnosis and treatment methods of chyluria, this paper aims to improve clinicians’ understanding of the disease, reduce the rate of missed diagnosis and misdiagnosis, and provide basis for clinical management of chyluria patients during pregnancy.