乳癌相关淋巴水肿的诊治研究进展  

RESEARCH ADVANCES IN THE DIAGNOSIS AND TREATMENT OF BREAST CANCER-RELATED LYMPHEDEMA

作　　者：郑圣齐[1] 何林 吕杨[3] 宋玉华[2] ZHENG Shengqi;HE Lin;LU Yang;SONG Yuhua(Department of Oncology Third Ward, The PLA Navy Anqing Hospital, Anqing 246000, China)

机构地区：[1]中国人民解放军海军安庆医院肿瘤三病区,安徽安庆246000 [2]青岛大学附属医院乳腺中心B病区 [3]中国人民解放军海军安庆医院肿瘤一病区

出　　处：《青岛大学学报（医学版）》2020年第4期495-499,共5页Journal of Qingdao University(Medical Sciences)

基　　金：山东省医药卫生科技发展计划项目(2016WSB-26051)。

摘　　要：许多乳癌诊疗措施在提高病人生存率的同时也会引起乳癌相关淋巴水肿(BCRL)的发生。体质量超标、肥胖、过多的阳性淋巴结数以及包膜肿瘤侵犯等也是BCRL的危险因素。越早开始临床干预和治疗,就越能有效地减少患肢的水肿体积和改善病人的生活质量。目前,治疗BCRL的方法主要包括综合消肿治疗、气动压缩装置辅助治疗、体育锻炼、显微外科手术和抽脂术等,但是尚未发现能治疗淋巴水肿的有效药物,近期在动物模型上应用的分子治疗的成功可能会弥补这一缺陷。有初步研究显示,自体干细胞移植可以减小患肢的体积且不会出现水肿的反弹,这可能为治疗BCRL提供了新的方法。本文主要综述了BCRL的发病机制、临床表现、风险因素、预防、诊断工具和监视方法、常规和新型治疗模式的特点等方面研究进展。Most diagnostic and treatment strategies for breast cancer patients can improve the survival rate of patients,but they may also lead to breast cancer-related lymphedema(BCRL).Overweight,obesity,excessive number of positive lymph nodes,and capsular tumor invasion are risk factors for BCRL.Earlier clinical intervention and treatment can more effectively reduce edema volume of affected limbs and improve patients’quality of life.At present,major treatment methods for BCRL include comprehensive detumescence treatment,adjuvant therapy with pneumatic compression device,physical exercise,microsurgery,and liposuction;however,no effective drugs have been found for the treatment of lymphedema,while the success of molecular therapy applied to animal models will compensate for this defect.In addition,some preliminary studies have showed that autologous stem cell transplantation can reduce the excessive volume of affected limbs without the recurrence of swelling,which may provide a new method for the treatment of BCRL.This article reviews the pathogenesis,clinical manifestations,risk factors,prevention,diagnostic and monitoring tools,and conventional and new treatment paradigms for BCRL.

关 键 词：乳腺癌淋巴水肿 诊断 治疗 综述 

分 类 号：R737.9[医药卫生—肿瘤]