下肢肿胀的诊断及鉴别诊断  

Diagnosis and differential diagnosis of lower extremity swelling

作　　者：罗家音 陈作观 李拥军[1] LUO Jia-yin;CHEN Zuo-guan;LI Yong-jun(Department of Vascular Surgery,National Center of Gerontolo-gy,Beijing Hospital,Beijing 100730,China)

机构地区：[1]国家老年医学中心、北京医院血管外科,北京100730

出　　处：《中国实用外科杂志》2023年第12期1352-1355,共4页Chinese Journal of Practical Surgery

基　　金：国家重点研发计划(No.2020YFC2008003);中国医学科学院医学与健康科技创新工程重大协同创新项目(No.CIFMS.2021-I2M-1-050)。

摘　　要：下肢肿胀可能是全身性或局部疾病的表现,需要综合病史、体征和辅助检查进行诊断和鉴别诊断。根据不同分类方式,可分为对称性或不对称性、凹陷性或非凹陷性、急性或慢性、感染性或非感染性、血管性或淋巴性等类型。下肢肿胀的常见原因包括静脉功能不全、深静脉血栓、心力衰竭、肝病、药物反应、淋巴水肿等。常用辅助检查包括多普勒超声、CT增强静脉造影显像、核磁共振静脉成像、淋巴管显像等。最终的诊断取决于综合的分析评估。Lower extremity swelling may be a manifestation of systemic or local diseases and requires comprehensive diagnosis and differential diagnosis based on history signs,and auxiliary examinations.According to different classification methods,it can be divided into symmetrical or asymmetrical pitting or non-pitting acute or chronic infectious or non-infectious and vascular or lymphatic types.The common causes of lower extremity swelling include venous insufficiency deep vein thrombosis heart failure liver disease drug reaction lymphedema,and so on.The commonly used auxiliary examinations include Doppler ultrasound,CT-enhanced venography imaging magnetic resonance venography imaging lymphangiography,and so on.The final correct diagnosis depends on comprehensive assessment.

关 键 词：下肢肿胀 下肢静脉功能不全 淋巴水肿 影像学检查 

分 类 号：R6[医药卫生—外科学]