Deep cervical lymph-venous anastomosis(LVA)is a surgical procedure initially developed to treat cervical lymphatic obstruction,such as lymphedema,a condition caused by the accumulation of lymphatic fluid due to blocke...Deep cervical lymph-venous anastomosis(LVA)is a surgical procedure initially developed to treat cervical lymphatic obstruction,such as lymphedema,a condition caused by the accumulation of lymphatic fluid due to blocked or damaged lymphatic vessels.In early 2024,Dr.Qingping Xie from Hangzhou Qiushi Hospital,China,and Dr.Wei F.Chen from the Cleveland Clinic,USA,adapted LVA for the treatment of patients with Alzheimer’s disease(AD).As a VIEWPOINT,they presented a video showcasing the post-surgery cognitive recovery of an 84-year-old AD patient(Xie et al.,2024).展开更多
目的探究颈深淋巴-静脉吻合术治疗阿尔茨海默病的短期疗效及安全性。方法本研究采用病例系列报道研究设计,所有病例资料(共30例)均来源于2024年12月至2025年2月在重庆医科大学附属第一医院神经外科接受颈深淋巴-静脉吻合术(lymphatic-ve...目的探究颈深淋巴-静脉吻合术治疗阿尔茨海默病的短期疗效及安全性。方法本研究采用病例系列报道研究设计,所有病例资料(共30例)均来源于2024年12月至2025年2月在重庆医科大学附属第一医院神经外科接受颈深淋巴-静脉吻合术(lymphatic-venous anastomosis,LVA)的患者。所有患者明确诊断为阿尔茨海默病,并在术前、术后1周、术后1个月和术后3个月时接受神经精神问卷(neuropsychiatric inventory,NPI)、临床痴呆评定量表(clinical dementia rating,CDR)和日常生活活动能力量表(Activities of daily living,ADL)3项神经心理学量表评估,并以其评分情况作为疗效评价指标。结果所有患者成功接受LVA,无死亡病例及严重不良事件发生。NPI评分中位数术后1周16.0(7.2,21.5)较术前25.5(13.8,47.5)降低(P<0.001,r=0.74),术后1个月17.0(8.5,23.8)及术后3个月17.5(12.0,21.0)基本保持稳定且与术前有统计学差异(P<0.001);ADL评分均值术后1周(54.9±16.2)较术前(56.7±16.6)降低(P<0.001),术后1个月(53.7±16.0)进一步降低(P<0.001),术后3个月(56.2±13.9)仍低于术前但不再具有统计学差异(P=0.701);CDR总分(Clinical dementia rating scale Sum of Boxes,CDR-SB)中位数术后1周15.0(13.0,16.0)较术前16.0(13.2,17.0)降低,差异具有统计学意义(P<0.001,r=0.63),术后1个月及术后3个月均与术前有统计学差异。结论LVA治疗阿尔茨海默病表现出较高的安全性,并对阿尔茨海默病症状改善具有一定的短期效果。展开更多
基金supported by AG057842 from the National Institutes of Health,TRIBA/Physiology Faculty Startup Fund from Augusta University (to FF)the National Natural Science Foundation of China (82173384)(to MG)
文摘Deep cervical lymph-venous anastomosis(LVA)is a surgical procedure initially developed to treat cervical lymphatic obstruction,such as lymphedema,a condition caused by the accumulation of lymphatic fluid due to blocked or damaged lymphatic vessels.In early 2024,Dr.Qingping Xie from Hangzhou Qiushi Hospital,China,and Dr.Wei F.Chen from the Cleveland Clinic,USA,adapted LVA for the treatment of patients with Alzheimer’s disease(AD).As a VIEWPOINT,they presented a video showcasing the post-surgery cognitive recovery of an 84-year-old AD patient(Xie et al.,2024).
文摘目的探究颈深淋巴-静脉吻合术治疗阿尔茨海默病的短期疗效及安全性。方法本研究采用病例系列报道研究设计,所有病例资料(共30例)均来源于2024年12月至2025年2月在重庆医科大学附属第一医院神经外科接受颈深淋巴-静脉吻合术(lymphatic-venous anastomosis,LVA)的患者。所有患者明确诊断为阿尔茨海默病,并在术前、术后1周、术后1个月和术后3个月时接受神经精神问卷(neuropsychiatric inventory,NPI)、临床痴呆评定量表(clinical dementia rating,CDR)和日常生活活动能力量表(Activities of daily living,ADL)3项神经心理学量表评估,并以其评分情况作为疗效评价指标。结果所有患者成功接受LVA,无死亡病例及严重不良事件发生。NPI评分中位数术后1周16.0(7.2,21.5)较术前25.5(13.8,47.5)降低(P<0.001,r=0.74),术后1个月17.0(8.5,23.8)及术后3个月17.5(12.0,21.0)基本保持稳定且与术前有统计学差异(P<0.001);ADL评分均值术后1周(54.9±16.2)较术前(56.7±16.6)降低(P<0.001),术后1个月(53.7±16.0)进一步降低(P<0.001),术后3个月(56.2±13.9)仍低于术前但不再具有统计学差异(P=0.701);CDR总分(Clinical dementia rating scale Sum of Boxes,CDR-SB)中位数术后1周15.0(13.0,16.0)较术前16.0(13.2,17.0)降低,差异具有统计学意义(P<0.001,r=0.63),术后1个月及术后3个月均与术前有统计学差异。结论LVA治疗阿尔茨海默病表现出较高的安全性,并对阿尔茨海默病症状改善具有一定的短期效果。
