继发性肢体淋巴水肿手术治疗的创新方案  

Innovative surgical approach for the treatment of secondary limb lymphedema

作　　者：谢庆平 吴建龙 索岩[2] 王海文 施泽田 Xie Qingping;Wu Jianlong;Suo Yan;Wang Haiwen;Shi Zetian(Qiushi Hospital,Hangzhou 310000,Zhejiang Province,China;Zhejiang Provincial People's Hospital(Affiliated People's Hospital),Hangzhou Medical College,Hangzhou 310000,Zhejiang Province,China;Chashan Hospital,Dongguan City 523000,Guangdong Province,China)

机构地区：[1]杭州求是医院,浙江杭州310022 [2]浙江省人民医院/杭州医学院附属人民医院,浙江杭州310014 [3]东莞市茶山医院,广东东莞523000

出　　处：《中国临床解剖学杂志》2025年第2期128-132,共5页Chinese Journal of Clinical Anatomy

基　　金：浙江省卫生厅科技计划项目(2024KY022)。

摘　　要：目的介绍一个关键点合并数个局部淋巴管静脉吻合术(Lymphaticovenous anastomosis,LVA)治疗继发性淋巴水肿的淋巴外科谢氏1+X治疗方式。方法2023年1月至2024年6月,本组11例因肿瘤根治术合并淋巴结清扫术后产生继发性淋巴水肿患者,肿瘤术后发生淋巴水肿时间为7~190月,平均时间为24.5月,未进行外科手术干预而导致肢体淋巴水肿病程为10~185月,平均为42.6月,上诉患者均采用谢氏1+X手术方式进行治疗。手术后随访时间2~12月,平均6.5月。结果分别记录患者手术前后肢体淋巴水肿程度、受累肢体分期、是否继发性蜂窝织炎及其发生时间。本组随访时间点为术前和术后1、3、6、12月。经手术前后各项指标比较,存在显著差异(P<0.05)。结论谢氏1+X显微治疗技术是综合治疗继发性淋巴水肿病因和现象的一种有效方案,具有治疗效果好,手术切口少,操作时间短的优势,可以作为继发性淋巴水肿较理想的手术方案使用。Objective To introduce the Xie's 1+X surgical approach,a lymphatic microsurgical technique that combines multiple local lymphaticovenous anastomosis(LVA)at key points for the treatment of secondary lymphedema.Methods From January 2023 to June 2024,a total of 11 patients who developed secondary lymphedema after tumor resection combined with lymphadenectomy were treated using the Xie's 1+X surgical approach.The onset of lymphedema after tumor surgery ranged from 7 to 190 months,with an average of 24.5 months.The duration of lymphedema before surgical intervention ranged from 10 to 185 months,with an average of 42.6 months.All patients underwent treatment using the Xie's 1+X surgical technique.The postoperative follow-up period ranged from 2 to 12 months,with an average of 6.5 months.Results The severity of limb lymphedema,the stage of the affected limb,and the presence and timing of secondary cellulitis were recorded before and after surgery.Follow-up evaluations were conducted at preoperative baseline and at 1,3,6,and 12 months postoperatively.There were significant differences in comparative analysis of preoperative and postoperative indicators(P<0.05).Conclusions The Xie's 1+X microsurgical technique is an effective approach for addressing both the underlying causes and manifestations of secondary lymphedema.It offers significant advantages,including high treatment efficacy,minimal surgical incisions,and shorter operative time,making it a promising surgical option for secondary lymphedema management.

关 键 词：继发性淋巴水肿 淋巴管静脉吻合术 1+X手术方案 

分 类 号：R616.2[医药卫生—外科学]