DSA引导下腰交感神经阻滞治疗妇科肿瘤术后下肢淋巴水肿  

DSA-guided lumbar sympathetic nerve block for treating lower limb lymphedema after surgical resection of gynecological tumors

作　　者：郑辉哲[1,2] 黄华清 林振孟 孙阳[3] ZHENG Huizhe;HUANG Huaqing;LIN Zhenmeng;SUN Yang(Department of Pain,Fujian Medical University Cancer Hospital,Fujian Cancer Hospital,Fuzhou 350108,China;Pain Research Laboratory,Fujian Medical University,Fuzhou 350122,China;Department of Gynecology,Fujian Medical University Cancer Hospital,Fujian Cancer Hospital,Fuzhou 350108,China)

机构地区：[1]福建医科大学附属肿瘤医院福建省肿瘤医院疼痛科,福建福州350108 [2]福建医科大学疼痛研究室,福建福州350122 [3]福建医科大学附属肿瘤医院福建省肿瘤医院妇科,福建福州350108

出　　处：《中国介入影像与治疗学》2021年第9期517-520,共4页Chinese Journal of Interventional Imaging and Therapy

基　　金：留学人员科技活动项目择优资助项目。

摘　　要：目的观察DSA引导下腰交感神经阻滞治疗妇科肿瘤术后下肢淋巴水肿的有效性及安全性。方法回顾性分析20例妇科肿瘤术后下肢淋巴水肿患者,均接受DSA引导下腰交感神经阻滞治疗(均治疗2次)。分别于阻滞前、首次阻滞后第1天及第2次阻滞后第1、7天测量患侧腿围,记录患侧腿围缩小值。采用Inbody720多频生物电阻人体成分分析仪检测阻滞前及第2次阻滞后1周时的组织水肿程度;观察症状改善及功能恢复情况。结果20例均顺利完成阻滞。1例术后出现短暂下肢无力,余无不良反应。首次阻滞后第1天及第2次阻滞后第1、7天患侧下肢各测量点腿围均不同程度缩小,且各测量点第2次阻滞术后第1、7天腿围缩小值均高于第1次术后第1天(P均<0.01)。第2次阻滞后1周组织水肿程度较术前降低(P<0.01),髋关节活动度较术前增加(P<0.01),患侧下肢肿胀感、紧绷感、疼痛感、麻木感均消失。结论DSA引导下腰交感神经阻滞治疗妇科肿瘤术后下肢淋巴水肿有效且安全。Objective To observe the efficacy and safety of DSA-guided lumbar sympathetic nerve block in treatment of lower limb lymphedema after surgical resection of gynecological tumors.Methods Twenty patients with lower limb lymphedema after surgical resection of gynecological tumor and underwent twice DSA-guided lumbar sympathetic nerve block were retrospectively analyzed.The circumferences of the involved legs were measured before block,the 1st day after the first block as well as the 1st and 7th days after the second block,and the reductions of circumferences of legs were recorded.The degrees of tissue edema were evaluated using an Inbody720 multifrequency bioelectrical resistance body composition analyzer before and 1 week after the second block,and the improvement of symptoms and functional recoveries were assessed.Results Lumbar sympathetic nerve block was successfully performed in all 20 patients.Transient weakness of the involved leg was observed in 1 case after treatment,while no other adverse reaction occurred.On the 1st day after the first block,the 1st and 7th days after the second block,the leg circumferences of the measured points of the involved legs decreased with various degrees(all P<0.01),and the reduction of leg circumferences on the 1st and 7th days after the second block were higher than that on the 1st day after the first block(all P<0.01).One week after the second block,the degrees of tissue edema decreased,and the motion ranges of hip joint increased compared with those pre-treatment(both P<0.01).The feeling of swelling,tightness,pain and numbness of the affected legs disappeared.Conclusion DSA-guided lumbar sympathetic nerve block was safe and effective for treating lower limb lymphedema after surgical resection of gynecological tumors.

关 键 词：淋巴水肿 下肢 血管造影术 数字减影 自主神经传导阻滞 

分 类 号：R551.2[医药卫生—血液循环系统疾病] R815[医药卫生—内科学]