颈深淋巴静脉吻合术治疗帕金森病的临床结果与短期随访  

Clinical outcomes and short-term follow-up of deep cervical lymphatic-venous anastomosis in the treatment of Parkinson's disease

作　　者：王海文 谢庆平 吴建龙 施泽田 温佳蓉 Wang Haiwen;Xie Qingping;Wu Jianlong;Shi Zetian;Wen Jiarong(Chashan Hospital,Dongguan 523000,Guangdong Province,China;Qiushi Hospital,Hangzhou 310000,Zhejiang Province,China;Zhejiang Provincial People's Hospital,Hangzhou 310000,Zhejiang Province,China;Graduate School of Chengde Medical College,Chengde 067400,Hebei Province,China)

机构地区：[1]东莞市茶山医院,广东东莞523000 [2]杭州求是医院,浙江杭州310022 [3]浙江省人民医院,浙江杭州310014 [4]承德医学院研究生院,河北承德067400

出　　处：《中国临床解剖学杂志》2025年第2期138-142,共5页Chinese Journal of Clinical Anatomy

基　　金：浙江省教育厅科技计划项目(Y202354092)。

摘　　要：目的探讨颈深淋巴静脉吻合术(dcLVA)治疗帕金森病的临床疗效,分别从运动障碍和认知障碍来评估帕金森患者术后的改善状况。方法自2024年4月至2024年12月,东莞市茶山医院收治8例帕金森病患者进行了颈深淋巴静脉吻合术。在吲哚菁绿荧光导航下,对颈深部淋巴系统进行显影,选取吲哚菁绿染色的颈部淋巴结分区为Ⅱ区、Ⅲ区的淋巴管与相邻静脉行端端吻合或Ⅳ区的淋巴结与颈外静脉主干行端侧吻合。统一采用帕金森病评分量表进行手术前、后预定时间点进行测量和评估。结果8例手术患者均未发生严重并发症。术后随访结果显示患者在运动功能障碍方面的改善表现显著,包括步态稳定性提高、震颤减轻和运动协调性增强。同时,认知功能障碍如睡眠质量、情绪稳定性、嗅觉和味觉功能也显示一定程度的改善。结论通过颈深淋巴静脉吻合术改善了脑内淋巴循环,降低脑内淋巴压力和促进脑代谢蛋白的清除,从而来改善帕金森病患者的临床症状。为帕金森病的治疗提供了新的思路。Objective To investigate the clinical efficacy of deep cervical lymphatic-venous anastomosis(dcLVA)in the treatment of Parkinson's disease,evaluating postoperative improvements in both motor and cognitive impairments in patients with Parkinson's disease.Methods From April 2024 to December 2024,8 patients with Parkinson's disease underwent dcLVA at Chashan Hospital in Dongguan.Under indocyanine green(ICG)fluorescence navigation,the deep cervical lymphatic system was visualized.Lymphatic vessels in ICG-stained cervical lymph node zones II and III were selected for end-to-end anastomosis with adjacent veins,or lymph nodes in zone IV were selected for end-to-side anastomosis with the external jugular vein trunk.The Unified Parkinson's Disease Rating Scale was used to measure and assess patients at predetermined time points before and after surgery.Results None of the 8 surgical patients experienced severe complications.Postoperative follow-up results showed significant improvements in motor dysfunction,including enhanced gait stability,reduced tremors,and improved motor coordination.Additionally,cognitive impairments such as sleep quality,emotional stability,and olfactory and gustatory functions also demonstrated some degree of improvement.Conclusions dcLVA improves intracranial lymphatic circulation,reduces intracranial lymphatic pressure,and promotes the clearance of brain metabolic proteins,thereby alleviating clinical symptoms in patients with Parkinson's disease.This provides a novel approach to the treatment of Parkinson's disease.

关 键 词：帕金森病 颈深淋巴静脉吻合术 临床疗效 

分 类 号：R616.2[医药卫生—外科学]