Vignes S, Boursier V, Trévidic P
Unité de Lymphologie, Hôpital Cognacq-Jay, Site Broussais, 102 rue Didot, 75674 Paris Cedex 14.
J Mal Vasc. 2005 Jul;30(3):181-5. doi: 10.1016/s0398-0499(05)83836-3.
Treatment of lymphedema is based upon decongestive physiotherapy including low stretch bandages. We reported 3 cases of huge primary lymphedema of lower limb treated with cutaneous resection after decongestive physiotherapy. Two men and a woman (47, 48, 48 years old) had unilateral right lymphedema which appeared at the age of 38, 38 and 37 years. Patients were hospitalized and treated during 3 to 5 weeks with decongestive physiotherapy and then followed by one (n=2) or two cutaneous (n=1) resections. Lymphedema volume calculated with the method of truncated cones decreased of 32, 38 and 59%. Largest differences between the two calves were 54, 38 and 57 cm before treatment and 17, 9 and 12 cm after treatment. Cutaneous resections on external side of the calf were longitudinal without complications. Lymphedema volume remained stable after 24, 6 and 12 months with two superposed elastic stockings and regular self bandaging.
淋巴水肿的治疗基于包括低弹力绷带在内的消肿物理治疗。我们报告了3例下肢巨大原发性淋巴水肿患者，在消肿物理治疗后接受了皮肤切除术。两名男性和一名女性（分别为47岁、48岁、48岁）患有单侧右下肢淋巴水肿，分别于38岁、38岁和37岁时出现。患者住院接受3至5周的消肿物理治疗，然后接受一次（n = 2）或两次（n = 1）皮肤切除术。采用截头圆锥体法计算，淋巴水肿体积分别减少了32%、38%和59%。治疗前，两侧小腿最大差值分别为54 cm、38 cm和57 cm，治疗后分别为17 cm、9 cm和12 cm。小腿外侧的皮肤切除术为纵向，无并发症。使用两层叠加的弹力袜并定期自行包扎后，24个月、6个月和12个月时淋巴水肿体积保持稳定。
