薄层血管化腹股沟淋巴结皮瓣移植联合反向淋巴显影在继发性上肢淋巴水肿手术中的应用  

Application of thin vascularized lymph node transfer combined with reverse mapping in the treatment of secondary upper extremity lymphedema

作　　者：廖晓明[1] 蒋奕[1] 唐玮[1] 杨华伟[1] 姬逸男[1] 韦莉颖 LIAO Xiaoming;JIANG Yi;TANG Wei;YANG Huawei;JI Yinan;WEI Liying(Department of Breast Surgery,Guangxi Medical University Cancer Hospital,Nanning 530021,China;College of Oncology,Guangxi Medical University,Nanning 530021,China)

机构地区：[1]广西医科大学附属肿瘤医院乳腺外科,广西壮族自治区南宁市530021 [2]广西壮族自治区南宁市广西医科大学肿瘤医学院,530021

出　　处：《组织工程与重建外科》2022年第1期8-13,共6页Journal of Tissue Engineering and Reconstructive Surgery

基　　金：广西医疗卫生适宜技术开发与推广应用项目(S2020095)。

摘　　要：目的探讨薄层血管化腹股沟淋巴结皮瓣移植联合反向淋巴显影在继发性上肢淋巴水肿手术中的应用效果。方法2019年7月至2020年9月,应用吲哚菁绿、美蓝双染法引导的反向淋巴显影术,制备薄层游离血管化腹股沟淋巴结皮瓣,切取后移植于患侧上肢,治疗乳腺癌术后继发性淋巴水肿患者5例。皮瓣约10 cm×5 cm大小,平均厚度约0.7 cm,切取供区淋巴结约2~3枚,术后随访7~15个月。结果5例皮瓣存活良好,淋巴结均存活。术后随访显示,患肢臂围均于1.5个月后出现明显缩小,供区无并发症。结论联合反向淋巴显影技术完成的薄层血管化淋巴结游离皮瓣移植治疗继发性上肢淋巴水肿疗效优良,明显改善患肢臃肿外形。Objective To explore the effect of thin vascularized lymph node transfer(VLNT)combined with reverse mapping in the treatment of secondary upper extremity lymphedema.Methods From July 2019 to September 2020,the free vascularized inguinal lymph node thin-layered flap was prepared by the reverse mapping guided by indocyanine green and methylene blue double staining,which was excised and transplant to the upper limb of the affected side to treat 5 patients with secondary lymphedema after the operation of breast cancer.The flap was about 10 cm×5 cm in size and 0.7 cm in thickness.About 2 to 3 lymph nodes in the donor area were excised.The patients were followed up for 7 to 15 months.Results All the flaps survived well and all lymph nodes survived.In postoperative follow-up,the circumference of the affected limb was significantly reduced 1.5 months later,and the donor area had no complications.Conclusion Thin VLNT combined with reverse mapping in the treatment of secondary upper extremity lymphedema has good efficacy and aesthetic effect.

关 键 词：薄层血管化腹股沟淋巴结皮瓣移植 淋巴水肿 吲哚菁绿 反向淋巴显影 乳腺癌 

分 类 号：R551.2[医药卫生—血液循环系统疾病]