手动负压抽吸联合血管化淋巴结移植治疗继发性下肢淋巴水肿的疗效分析  

Simultaneous application of vascularized lymph nodes transfer and liposuction for treatment of secondary lymphedema of the lower extremities

作　　者：魏苗苗 吴祥奎 吴必华 张天华 李海 肖顺娥 魏在荣 邓呈亮 WEI Miaomiao;WU Xiangkui;WU Bihua;ZHANG Tianhua;LI Hai;XIAO Shun'e;WEI Zairong;DENG Chengliang(Department of Burn and Plastic surgery,Affiliated Hospital of Zunyi Medical University,Collaborative Innovation Center of Tissue Damage Repair and Regeneration Medicine,Zunyi 563003,China)

机构地区：[1]遵义医科大学附属医院烧伤整形外科,组织损伤修复与再生医学省部共建协同创新中心,贵州省遵义市563003

出　　处：《组织工程与重建外科》2022年第1期14-18,共5页Journal of Tissue Engineering and Reconstructive Surgery

基　　金：贵州省科技计划重点项目[黔科合基础-ZK(2021)重点011];省部共建协同创新中心项目[教科技厅函(2020)39号]。

摘　　要：目的探讨手动负压抽吸联合血管化淋巴结移植治疗继发性下肢淋巴水肿的临床疗效。方法回顾性分析2018年11月至2021年11月接受联合治疗的12例妇科恶性肿瘤术后继发性下肢淋巴水肿患者的临床资料。患肢大腿采用手动负压抽吸减容,同时取锁骨上血管化淋巴结移植至患侧小腿。比较治疗前后患肢周径变化;记录治疗前后丹毒发作情况及生活质量的改变。结果患肢大腿抽取脂肪组织500~1200 mL,平均(917±196)mL。术后患肢周径明显减小(P<0.05)。治疗后随访期间所有患者均无丹毒发作,主观症状均较术前明显好转。结论手动负压抽吸联合血管化淋巴结移植治疗下肢淋巴水肿疗效确切,值得推广。Objective To investigate the clinical efficacy of liposuction combined with vascularized lymph nodes transfer in the treatment of secondary lymphedema of the lower extremities.Methods A retrospective analysis was performed on the clinical data of 12 patients with secondary lymphedema of the lower extremity after gynecological malignant tumor surgery from November 2018 to November 2021.The volume of the affected thigh was reduced by liposuction,and the supraclavicular vascularized lymph nodes were removed and transplanted to the lower leg.Paired T test was used to compare the circumference of the affected extremities before and after treatment.Meanwhile,the incidence of erysipelas and the change of quality of life before and after treatment were recorded.Results About 500-1200 mL adipose tissue was extracted from the thigh of the affected limb,with an average of(917±196)mL.The diameter of the affected extremities was significantly reduced after operation(P<0.05).No erysipelas occurred during follow-up,and the subjective symptoms were significantly improved while compared with those before operation.Conclusion Liposuction combined with vascularized lymph nodes transfer is an effective method for the treatment of lower extremity lymphedema,and is worthy of clinical application.

关 键 词：淋巴水肿 抽脂术 血管化淋巴结移植 

分 类 号：R551.2[医药卫生—血液循环系统疾病]