锁骨上血管化淋巴结移植治疗淋巴水肿的研究进展  

Advances in treatment of lymphedema with supraclavicular vascularized lymph node transfer

作　　者：潘文杰 邓呈亮 PAN Wenje;DENG Chengliang(Department of Burns and Plastic Surgery,Afiliated Hospital of Zunyi Medical University,Zunyi Guizhou,563003,P.R.China;Collaborative Innovation Center of Tissue Repair and Regenerative Medicine,Zunyi Guizhou,563003,P.R.China)

机构地区：[1]遵义医科大学附属医院烧伤整形外科,贵州遵义563003 [2]组织损伤修复与再生医学省部共建协同创新中心,贵州遵义563003

出　　处：《中国修复重建外科杂志》2023年第6期736-741,共6页Chinese Journal of Reparative and Reconstructive Surgery

基　　金：国家自然科学基金资助项目(82260391);省部共建协同创新中心项目[教科技厅函(2020)39号]。

摘　　要：目的对锁骨上血管化淋巴结移植(vascularized lymph node transfer,VLNT)的研究进展作一综述。方法广泛查阅近年国内外锁骨上VLNT相关研究文献,从锁骨上淋巴结解剖、锁骨上VLNT临床应用及并发症方面进行归纳总结。结果锁骨上淋巴结解剖位置恒定,位于颈后三角区域,血供主要来自于颈横动脉。锁骨上淋巴结数量存在个体差异,术前可进行超声检查以明确淋巴结数量。临床研究表明锁骨上VLNT能改善淋巴水肿患者的肢体肿胀、减少感染发生率和提高生活质量,同时也能联合淋巴管静脉吻合、切除手术以及抽脂术,提高治疗效果。结论锁骨上淋巴结数量较多,血供丰富,锁骨上VLNT已被证实对任何时期的淋巴水肿均有效,联合治疗效果更显著。但是需更多临床研究来明确锁骨上VLNT单独或联合应用的治疗效果以及联合治疗的手术方式、手术时机选择。Objective To review the research progress of supraclavicular vascularized lymph node transfer(VLNT).Methods The research literature related to supraclavicular VLNT at home and abroad in recent years was extensively reviewed,and the anatomy of supraclavicular lymph nodes,clinical applications,and complications of supraclavicular VLNT were summarized.Results The supraclavicular lymph nodes are anatomically constant,located in the posterior cervical triangle zone,and the blood supply comes mainly from the transverse cervical artery.There are individual differences in the number of supraclavicular lymph nodes,and preoperative ultrasonography is helpful to clarify the number of lymph nodes.Clinical studies have shown that supraclavicular VLNT can relieve limb swelling,reduce the incidence of infection,and improve quality of life in patients with lymphedema.And the effectiveness of supraclavicular VLNT can be improved by combined with lymphovenous anastomosis,resection procedures,and liposuction.Conclusion There are a large number of supraclavicular lymph nodes,with abundant blood supply.It has been proven to be effective for any period of lymphedema,and the combined treatment is more effective.The more clinical studies are needed to clarify the effectiveness of supraclavicular VLNT alone or in combination,as well as the surgical approach and timing of the combined treatment.

关 键 词：淋巴水肿 锁骨上淋巴结 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]