中国修复重建外科杂志

中国修复重建外科杂志

血管化淋巴结移植治疗肢体淋巴水肿的研究进展

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目的 综述血管化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血管化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,血管化淋巴结组织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机制的两种主要假说,但目前均缺少确切的证据证实。临床研究提示,血管化淋巴结组织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 血管化淋巴结组织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; 血管化淋巴结移植; 动物实验; 临床试验

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

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