中国修复重建外科杂志

中国修复重建外科杂志

淋巴水肿的显微外科治疗进展

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目的 综述显微外科技术治疗淋巴水肿的临床研究进展。 方法 查阅近年国内外有关淋巴水肿的显微外科治疗研究文献,并进行总结分析。 结果 目前对于淋巴水肿以保守治疗为主,但只能在早期延缓疾病进程,无法达到治愈效果,且对患者依从性要求高。显微外科治疗方法可以较好地解决上述问题,显示出更理想的治疗效果,包括淋巴管静脉吻合术(lymphatic-venous anastomosis,LVA)、血管化淋巴结移植术(vascularized lymph node transfer,VLNT)以及其他淋巴管再造术等。 结论 以 LVA 及 VLNT 为代表的显微外科治疗手段应用逐渐增多,其有效性及安全性得到肯定,但仍需长期随机对照研究证据来制定标准诊疗规范。

Objective To review the clinical progress of microsurgical management for lymphedema. Methods The literature on microsurgical treatment for lymphedema at home and abroad in recent years was reviewed and analyzed. Results At present, conservative treatment is the main treatment for lymphedema, which has limited effectiveness only for early stages of lymphedema; and it is not curative and demands patient compliance. In contrast, microsurgical approaches can solve the problems in the prevention or management of lymphedema and showed promising results, such as lymphatic-venous anastomosis (LVA), vascularized lymph node transfer (VLNT), and other lymphatic reconstructions. Conclusion Microsurgical approaches like LVA and VLNT have been broadly used in recent years, the effectiveness and safety have been proved. But the evidence of long-term randomized controlled studies is still required to establish standard treatment practices.

关键词: 淋巴水肿; 显微外科; 淋巴管静脉吻合; 淋巴结移植

Key words: Lymphedema; microsurgery; lymphatic-venous anastomosis; lymph node transfer

引用本文: 刘士强, 马显杰. 淋巴水肿的显微外科治疗进展. 中国修复重建外科杂志, 2018, 32(9): 1223-1226. doi: 10.7507/1002-1892.201803018 复制

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