Schmidt K R, Welter H, Pfeifer K J, Becker H M
Rofo. 1978 Feb;128(2):194-202. doi: 10.1055/s-0029-1230824.
In 37 patients, oedema of the legs was observed following successful femoro-popliteal surgery; lymphangiograms were performed between the third and ninth post-operative days and the intact lymph vessels at the knee and at the groin were counted. In 27 patients there was partial to total disruption of the lymphatic vessels. There was a clear correlation between the degree of swelling of the leg and thigh with the number of not divided lymphatic vessels at the knee and groin. In the presence of more than three intact lymph vessels, swelling amounted to only 1 to 2 cm., whereas if all lymph vessels had been divided, swelling amounted to 7 cm. Extensive soft tissue trauma and repeat surgery resulted in a greater reduction in intact lymph vessels and correspondingly more oedema than was found with more conservative surgery and after initial operations. The pre-operative condition of the arteries, the presence of venous disease and the postoperative blood-flow in the leg had no influence on postoperative oedema. In order to avoid post-operative lymphoedema, it is necessary to preserve the lymphatics during surgery. Marked oedema requires treatment consisting of compression bandages and medicaments.
在37例患者中,股腘动脉手术后成功观察到腿部水肿;在术后第3天至第9天进行淋巴管造影,并对膝关节和腹股沟处完整的淋巴管进行计数。27例患者的淋巴管出现部分至完全中断。腿部和大腿的肿胀程度与膝关节和腹股沟处未被切断的淋巴管数量之间存在明显的相关性。当存在超过三条完整的淋巴管时,肿胀仅为1至2厘米,而如果所有淋巴管都被切断,肿胀则达到7厘米。广泛的软组织创伤和重复手术导致完整淋巴管的减少更为明显,相应地比更保守的手术和初次手术后出现更多的水肿。术前动脉状况、静脉疾病的存在以及术后腿部的血流对术后水肿没有影响。为避免术后淋巴水肿,手术期间有必要保留淋巴管。明显的水肿需要采用加压绷带和药物进行治疗。