中国修复重建外科杂志

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带血运淋巴结移植治疗肢体淋巴水肿的研究进展

钱幼蕾 , 杨锴 , 穆籣

北京大学人民医院整形美容科（北京  100034）

收稿日期: 2018-01-12;  修回日期:2018-05-11; 

基金项目: 北京大学人民医院研究与发展基金（RDD2016-05）

通讯作者: 穆籣, Email: mulan666@aliyun.com

Research progress of vascularized lymph node transfer for extremity lymphedema

QIAN Youlei , YANG Kai , MU Lan

Department of Plastic & Medical Aesthetic Surgery, Peking University People’s Hospital, Beijing, 100034, P.R.China

Corresponding Author: MU Lan, Email: mulan666@aliyun.com

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目的 综述带血运淋巴结移植治疗肢体淋巴水肿的动物及临床研究进展。 方法 广泛查阅近年来国内外有关带血运淋巴结移植治疗肢体淋巴水肿的相关研究文献，进行分析总结。 结果 动物实验提示，与无血管吻合的淋巴结移植相比，带血运淋巴结移植可提高淋巴结成活率，有效减轻肢体淋巴水肿。虹吸假说和淋巴结泵假说是淋巴结移植治疗淋巴水肿两种主要可能机制，但目前均缺少确切的证据证实。临床研究提示，带血运淋巴结移植可显著降低患肢水肿程度，但研究随访时间较短，因远期存在淋巴水肿复发风险，所以该术式疗效有待长期、大规模临床研究进一步验证。 结论 带血运淋巴结移植可以有效缓解淋巴水肿症状，但其有效性及机制仍需要进一步研究。

Objective To review the current progress of clinical and experimental research of vascularized lymph node transfer for lymphedema. Methods The domestic and abroad literature about vascularized lymph node transfer in treatment of lymphedema was reviewed and analyzed. Results Experimental studies in animal model indicate that vascularized lymph node transfer can improve lymph node survival and show a promising effectiveness in reducing lymphedema. " Lymphatic wick” and " lymph pump” were the two main hypotheses proposed to explain the potential functional mechanism of vascularized lymph node transfer in treatment of lymphedema. Improvement in lymphedema symptoms are reported in most of the clinical trials, but the level of evidence to advocate this procedure in the treatment of lymphedema remains low because of the small number of the cases and problems in their methodologies. Conclusion Based on current evidence, vascularized lymph node transfer seems to be a promising treatment for lymphedema, but long-term well-designed studies are required to further explore the effectiveness of this procedure.

关键词: 淋巴水肿; 带血运淋巴结移植; 动物实验; 临床试验

Key words: Lymphedema; vascularized lymph node transfer; animal experiment; clinical trial

引用本文： 钱幼蕾, 杨锴, 穆籣. 带血运淋巴结移植治疗肢体淋巴水肿的研究进展. 中国修复重建外科杂志, 2018, 32(8): 979-983. doi: 10.7507/1002-1892.201801069 复制

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