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淋巴水肿的诊断与管理。

Lymphedema diagnosis and management.

作者信息

Gary Dayna E

机构信息

School of Nursing, University of Maryland at Baltimore, Baltimore, Maryland, USA.

出版信息

J Am Acad Nurse Pract. 2007 Feb;19(2):72-8. doi: 10.1111/j.1745-7599.2006.00198.x.

Abstract

PURPOSE

To provide advanced practice nurses with a greater understanding of the pathophysiology, clinical manifestations, diagnosis, and management of lymphedema.

DATA SOURCES

Comprehensive literature review of the relevant clinical journals, systematic reviews, and medical textbooks.

CONCLUSIONS

Lymphedema is a poorly known and understood condition. If not properly diagnosed and promptly treated, lymphedema can cause significant morbidity and mortality. Diagnosis is based on suggestive history and characteristic findings on physical exam that ideally would be confirmed by lymphoscintigraphy. The primary goal in lymphedema treatment is the removal of excess plasma proteins from the interstitial tissues. The goals of management are to decrease the extremity size, maintain the decreased size, prevent complications, and improve function and overall sense of psychological well-being.

IMPLICATIONS FOR PRACTICE

The ability to properly diagnose lymphedema is crucial to prevent the significant morbidity and mortality that is associated with this condition. It is imperative that patients with lymphedema are referred to specially trained healthcare professionals to ensure optimal treatment.

摘要

目的

使高级执业护士对淋巴水肿的病理生理学、临床表现、诊断及管理有更深入的了解。

资料来源

对相关临床期刊、系统评价及医学教科书进行全面的文献综述。

结论

淋巴水肿是一种鲜为人知且了解不足的病症。若未得到正确诊断和及时治疗,淋巴水肿可导致严重的发病率和死亡率。诊断基于提示性病史和体格检查的特征性发现,理想情况下应由淋巴闪烁造影术予以证实。淋巴水肿治疗的主要目标是从间质组织中清除多余的血浆蛋白。管理目标是减小肢体尺寸、维持减小后的尺寸、预防并发症以及改善功能和整体心理健康感。

对实践的启示

正确诊断淋巴水肿的能力对于预防与此病症相关的严重发病率和死亡率至关重要。必须将淋巴水肿患者转诊至经过专门培训的医护专业人员处,以确保获得最佳治疗。

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