摘要
目的:分析下肢继发性淋巴水肿患者淋巴管硬化的影响因素。方法:选取2022年1月-2023年12月于笔者科室行淋巴静脉吻合术的76例患者为研究对象,记录并分析患者的相关病历资料,包括患者年龄、BMI、水肿时间、放疗史、化疗史、既往患肢感染次数、并发症、切口部位、吲哚菁绿(ICG)淋巴造影分期以及淋巴管硬化程度的分级。根据术中观察淋巴管硬化的状况,将其分为非硬化型淋巴管组(非硬化组)和硬化型淋巴管组(硬化组)。采用SPSS 27.0对数据进行统计学分析,将单因素分析显示有统计学意义的变量纳入二元Logistic回归分析。结果:本研究共分析了312条淋巴管,其中46条(14.7%)淋巴管被确定为硬化型,纳入硬化组;266条(85.3%)被确定为非硬化型,纳入非硬化组。单因素分析显示,非硬化组和硬化组在BMI、水肿时间、放疗史、既往患肢感染次数、切口部位以及ICG分期方面的差异具有统计学意义(P<0.05)。多因素二元Logistic回归分析发现,与硬化型淋巴管相关的独立危险因素是较高的体重指数(OR=1.067;P<0.05),有放疗史(OR=2.987;P<0.05),既往肢体感染大于2次(OR=1.208;P<0.05),脚踝切口(OR=4.178;P<0.05),ICG分期Ⅳ期(OR=12.124;P<0.05)。结论:较高的BMI、有放疗史、既往感染大于2次、脚踝切口、ICG淋巴造影Ⅳ期是下肢继发性淋巴水肿患者淋巴管硬化的独立危险因素。其中ICG分期Ⅳ期与硬化型淋巴管有着最强的相关性。
Objective To analyze the influencing factors of lymphatic vessel fibrosis in patients with secondary lower limb lymphedema.Methods Seventy-six patients who underwent lymphatic venous anastomosis in our department from September 2021 to December 2023 were reviewed,and the relevant medical records of the patients were recorded and analyzed.They included patients'age,BMI,duration of edema,history of radiotherapy,history of chemotherapy,number of previous infections of the afected limb,comorbidities,incision site,indocyanine green(ICG)lymphography stage,and grading of the degree of lymphatic sclerosis.Based on the status of lymphatic sclerosis observed intraoperatively,the lymphatic vessels were categorized into the non-sclerotic lymphatic vessel group(non-sclerotic group)and the sclerotic lymphatic vessel group(sclerotic group).SPSS 27.0 was used to analyze the data statistically.P<0.05 was taken as statistically significant diference.Variables that showed statistical significance in single-factor analysis were included in binary logistic regression analysis.Results A total of 312 lymphatic vessels were analyzed in this study,among which 46(14.7%)were identified as fibrotic type and included in the fibrotic group,while 266(85.3%)were identified as non-fibrotic type and included in the non-fibrotic group.Univariate analysis showed statistically significant diferences between the non-fibrotic and fibrotic groups in BMI,edema duration,history of radiotherapy,previous limb infection count,incision site,and ICG staging(P<0.05).Multivariate binary logistic regression analysis revealed that the independent risk factors associated with fibrotic lymphatic vessels were higher body mass index(OR=1.067;P<0.05),history of radiotherapy(OR=2.987;P<0.05),previous limb infections more than 2 times(OR=1.208;P<0.05),ankle incision(OR=4.178;P<0.05),and ICG stage Ⅳ(OR=12.124;P<0.05).Conclusion In this research,higher BMI,history of radiotherapy,greater than 2 previous infections,ankle incision,and ICG lymphography stage Ⅳ were independent correlates of sclerotic lymphatics secondary to lower extremity lymphedema.Among them,ICG lymphography stage Ⅳ had the strongest correlation with sclerotic lymphatics.
作者
夏林曦
刘建科
周煦川
马戈甲
王文飞
秦傲霜
何海山
刘宾
XIA Linxi;LIU Jianke;ZHOU Xuchuan;MA Gejia;WANG Wenfei;QIN Aoshuang;HE Haishan;LIU Bin(Department of Burns and Plastic Surgery,Xi'an Central Hospital,Xi'an 710000,Shaanxi,China)
出处
《中国美容医学》
2026年第1期37-41,共5页
Chinese Journal of Aesthetic Medicine
基金
西安市创新能力强基计划-医学研究项目(编号:22YXYJ0077)。
