静脉淋巴管复合组织瓣移植在治疗下肢继发性淋巴水肿中的作用  

Treatment of Secondary Lower Extremity Lymphedema by Transplanting the Pedicle Adipo-lymphatico Venous Flap of the Great Saphenous Vein

作　　者：施越冬[1] 张学军[1] 徐剑炜[1] 顾建英[1] 亓发芝[1] 

机构地区：[1]复旦大学附属中山医院整形外科,上海200032

出　　处：《中国临床医学》2005年第5期831-834,共4页Chinese Journal of Clinical Medicine

摘　　要：目的：探讨大隐静脉淋巴管脂肪复合组织移植在治疗阻塞性淋巴水肿中的作用。方法：单侧阻塞性淋巴水肿患者10例分别于 术前、术后2周以及术后半年进行肢体周径测定、同位素淋巴管造影检查。5例应用大隐静脉淋巴管复合组织结合负压抽吸治疗(A 组)，5例行单纯肢体淋巴水肿负压抽吸治疗(B 组)。结果：A 组术后2周肢体周径较术前明显缩小(P＜0． 05) ；半年后肢体周径与术 前比较亦明显改善(P＜0． 05) ；而术后2周与术后半年的肢体周径无明显变化(P＞0． 05) 。同位素淋巴管造影显示淋巴回流有不同程 度改善。B 组肢体周径半年内改善较明显，但淋巴回流改善不明显。结论：采用带蒂大隐静脉淋巴管复合组织瓣移植结合负压抽吸 治疗单侧肢体继发性淋巴水肿在临床上具有一定的可行性。Objective： To determine the possibility of the treatment of the secondary lower extremity lymphedema by transplanting the pedicle adipo-lymphatico venous flap of the great saphenous vein. Methods： Ten patients with the secondary lower extremity lymphedema were studied, and the circumferences of the different parts of the lower extremity were measured and the 99Tc lymphangiographies were taken before surgery, in two weeks and half a year after operation in each case. Transplantation of the pedicle adipo-lymphatico venous flap of the great saphenous vein assisted by suction （Group A, n = 5）, suction only （Group B, n = 5）. Results： In Group A, the circumferences of the affected limbs were significantly reduced in 2 weeks after surgery. There were statistically significant differences of the changes of the circumferences between pre-operation and 2 weeks post-operation （P〈0. 05）. Meanwhile, there were statistically significant differences of the changes of the circumferences between pre-op and half a year post-op as well （P〈0. 05）. Nevertheless, there were no statistically significant differences of the changes of the circumferences between the 2 weeks post-op and half a year post-op （P〉0. 05）. The 99Tc lym- phangiography showed some improvements of the lymph refluence of the sick limb as well. The limb circumferences were also enhanced significantly in Group B. But, there were no major changes of the lymphatic refluence. Conclusion：Transplanting the pedicle adipo-lymphatico venous flap of the great saphenous vein assisted by suction is a useful tool to treat secondary lower extremity lymphedema.

关 键 词：淋巴水肿 大隐静脉 淋巴管 复合组织瓣 

分 类 号：R551.2[医药卫生—血液循环系统疾病]