摘要
淋巴水肿是因外部或自身因素引起的淋巴管输送功能障碍造成的渐进性发展的疾病,早期以水肿为主,晚期以组织纤维化、脂肪沉积和炎症等增生性病变为特征。淋巴水肿在世界卫生组织的《国际疾病分类》中被定义为一种疾病。目前淋巴水肿尚不能根治,需长期的甚至是终生的维护和呵护。淋巴水肿分为原发性和继发性两大类。曾经是继发性淋巴水肿主要患者群的丝虫性淋巴水肿,在我国本土已经多年没有新发病例。然而随着我国恶性肿瘤发病率和发病人数的不断攀升,癌症治疗后的淋巴水肿已经成为继发性淋巴水肿的主要病因。相对于庞大的病患人数,我国的淋巴水肿的专业医疗人员短缺,淋巴水肿的专业知识也不够普及。为统一外周淋巴水肿的定义、诊断和治疗标准,规范临床诊治,改善患者预后及生活质量,中华整形外科学分会淋巴水肿治疗学组启动了外周淋巴水肿诊疗中国专家共识的制定。共识包括淋巴水肿的病因学、病理生理学、临床诊断和辅助诊断、手术治疗和非手术治疗、疗效的维护和患者的教育。该共识的制定基于国内外最新临床和基础研究的经验,着重于实用性和普及性,提出淋巴水肿的Ⅰ~Ⅳ分期,对于显微淋巴外科、综合消肿治疗、远红外辐射热疗、同位素淋巴造影、磁共振淋巴造影及吲哚菁绿淋巴造影诊断进行评价,从而促进我国淋巴学的进一步发展。
Lymphedema is a chronic disease caused by dysfunction of lymphatic transport,characterized by swelling in the early stage and hyperplastic lesions such as tissue fibrosis,fat deposition and inflammation in the late stage.Lymphedema is defined as a disease in the WHO’s international classification of diseases.Currently lymphedema is incurable and needs life-long treatment and care.Filarial lymphedema,once a major secondary lymphedema type in China,has not been reported in China for many years.However,with the increasing incidence of malignant tumors nationwide,lymphedema after cancer treatment has become the main cause of secondary lymphedema.The Chinese Society of Plastic Surgery Lymphedema Group intended to define a consensus on the diagnostic and therapeuticguidelines for patients with peripherallymphedema,in light ofdomestic and international literature-based evidence,both clinical and investigative.The current consensus includes etiology of primary and secondary lymphedema;systemic evaluation;assessment of lymphatic system anomalies and tissue pathology with lymphoscintigraphy,MR lymphangiography,and ICG lymphography;conservative treatment with complete decongestion therapy(CDT)and far-infrared radiation thermotherapy;microsurgical and liposuction treatment.Lymphedema is assessed by stageⅠ-Ⅳ.It is the author’intent that this document stimulates nationwide further inquiry and discussion regarding all aspects of lymphedema diagnosis and treatment.
作者
无
刘宁飞
无;Lili Ningfei(The Chinese Society of Plastic Surgery Lymphedema Grou;不详)
出处
《中华整形外科杂志》
CAS
CSCD
北大核心
2020年第4期355-360,共6页
Chinese Journal of Plastic Surgery
关键词
淋巴水肿
恶性肿瘤
显微外科
淋巴造影术
综合消肿治疗
Lymphedema
Cancer related
Microlymphatic surgery
Lymphography
Complete decongestion therapy
