| 殷子兴,李学渊.上肢淋巴水肿的显微治疗进展[J].浙江中西医结合杂志,2026,36(2): |
| 上肢淋巴水肿的显微治疗进展 |
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| 投稿时间：2024-11-11 修订日期：2025-05-07 |
| DOI： |
| 中文关键词: 显微外科、上肢淋巴水肿、乳腺癌术后并发症 |
| 英文关键词:Microsurgery,Upper limb lymphedema,Postoperative complications of breast cancer |
| 基金项目: |
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| 中文摘要: |
| 上肢淋巴水肿是乳腺癌术后最严重的并发症之一,目前普遍认为其机制是乳腺癌腋窝淋巴结转移的患者在腋窝淋巴结清扫时破环了上肢淋巴回流通路,从而导致上肢淋巴液回流受阻,致使含大量蛋白的淋巴液瘀滞在组织间隙,破坏了血管内外胶体渗透压的平衡,从而引起的上肢淋巴水肿 [1, 2]。其引起的患者上肢严重变形、变重、功能障碍等问题进一步影响了乳腺癌患者的生活质量 [3]。为了预防及治疗上肢淋巴水肿,国内外学者通过大量临床研究及随访,提出了各种各样的解决方法,包括非手术治疗(压力衣),抽脂手术等,其中显微外科技术通过淋巴静脉吻合或淋巴结移植被证明能有效解决乳腺癌术后相关淋巴水肿,是目前治疗及预防的主流技术 [4]。 |
| 英文摘要: |
| Upper limb lymphedema is one of the most serious complications after breast cancer surgery. Currently, it is generally believed that the mechanism is that patients with axillary lymph node metastasis of breast cancer break the upper limb lymph return pathway during axillary lymph node dissection, which leads to the obstruction of upper limb lymph return, resulting in the stagnation of lymph fluid containing a large amount of protein in the tissue space, destroying the balance of colloid osmotic pressure inside and outside blood vessels. The resulting upper limb lymphedema[1, 2]. The severe deformation, weight gain and dysfunction of upper limbs caused by breast cancer further affect the quality of life of breast cancer patients [3]. In order to prevent and treat upper limb lymphedema, domestic and foreign scholars have proposed a variety of solutions through a large number of clinical studies and follow-up, including non-surgical treatment (pressure clothing), liposuction surgery, etc. Microsurgical techniques have been proved to be effective in solving postoperative lymphedema related to breast cancer through lympho-venous anastomosis or lymph node transplantation. It is currently the mainstream technology for treatment and prevention [4]. |
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