综合消肿治疗与静脉-淋巴管吻合术在中重度淋巴水肿患者中的效果比较  

Comparison of combined deswelling treatment and veno-lymphatic anastomosis in patients with moderate and severe lymphedema

作　　者：丁志娟 余腾骅 周菁 曾小强 DING Zhijuan;YU Tenghua;ZHOU Jing;ZENG Xiaoqiang(Breast Surgery Ward 3,Jiangxi Provincial Cancer Hospital,Jiangxi Province,Nanchang330029,China)

机构地区：[1]江西省肿瘤医院乳腺外科三病区,江西南昌330029

出　　处：《中国当代医药》2025年第1期34-37,共4页China Modern Medicine

基　　金：国家自然科学基金资助项目(82160565);江西省肿瘤医院“双青人才计划”资助项目(2021DYS04)。

摘　　要：目的探讨综合消肿治疗(CDT)和静脉-淋巴管吻合手术(LVA)在中重度淋巴水肿患者中的疗效。方法选取2021年8月至2022年3月在江西省肿瘤医院行乳腺癌手术后复诊确认发生上肢中重度淋巴水肿的32例患者作为研究对象,采取随机数字表法分为LVA组(采用LVA干预)及CDT组(采用CDT干预),每组各16例。比较两组患者治疗前,治疗后3、6、12个月的健、患侧上肢周径差值,细胞外液/细胞内液(ECW/ICW),细胞外液/体液总量(ECW/TBW),乳腺癌相关淋巴水肿症状指数(BCLE-SEI)量表评分。结果治疗后3、6、12个月,LVA组的健、患侧周径差值低于CDT组,差异有统计学意义(P<0.05)。LVA组治疗后12个月的ECW/ICW、ECW/TBW低于CDT组,差异有统计学意义(P<0.05)。LVA组治疗后6、12个月的BCLE-SEI量表评分低于CDT组,差异有统计学意义(P<0.05)。结论乳腺癌术后并发上肢中重度水肿采用LVA干预能显著改善患者的水肿症状。Objective To investigate the efficacy of comprehensive decongestive therapy(CDT)and veno-lymphatic anastomosis(LVA)in patients with moderate and severe lymphedema.Methods Thirty-two patients diagnosed with moderate to severe upper limb lymphedema after breast cancer surgery in Jiangxi Provincial Cancer Hospital from August 2021 to March 2022 were selected as the study objects.They were divided into LVA group(using LVA intervention)and CDT group(using CDT intervention)according to random number table method,with 16 cases in each group.The differences in circumference of healthy and affected upper limbs,extracellular/intracellular fluid(ECW/ICW),total extracellular/body fluid(ECW/TBW),breast cancer and lymphedema symptom experience index(BCLE-SEI)scale were compared between the two groups before treatment and 3,6 and 12 months after treatment.Results At 3,6 and 12 months after treatment,the differences of healthy and affected side diameter in LVA group were lower than those in CDT group,the differences were statistically significant(P<0.05).ECW/ICW and ECW/TBW in LVA group were lower than those in CDT group at 12 months after treatment,and the differences were statistically significant(P<0.05).The BCLE-SEI scale scores of LVA group at 6 and 12 months after treatment were lower than those of CDT group,and the differences were statistically significant(P<0.05).Conclusion LVA intervention can significantly improve the edema symptoms of patients with moderate and severe upper limb lymphedema after breast cancer surgery.

关 键 词：乳腺癌 上肢淋巴水肿 综合手法治疗 静脉-淋巴管吻合术 

分 类 号：R737.9[医药卫生—肿瘤]