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腿部肿胀

[Leg swelling].

作者信息

Schellong S M, Wollina U, Unger L, Machetanz J, Stelzner C

机构信息

Medizinische Klinik 2, Krankenhaus Dresden-Friedrichstadt, Städtisches Klinikum, Friedrichstr. 41, 01067, Dresden, Deutschland,

出版信息

Internist (Berl). 2013 Nov;54(11):1294-303. doi: 10.1007/s00108-013-3339-z.

Abstract

Leg swelling is an extremely frequent symptom with a broad variety of largely differing causes. The most important mechanisms behind the symptom include venous and lymphatic pathology, volume overload, increased capillary permeability, and lowered oncotic pressure. Therefore, the most frequent diseases associated with leg swelling are deep vein thrombosis and chronic venous insufficiency, primary or secondary lymphedema, cardiac failure, hypoproteinemia due to liver or renal failure, idiopathic cyclic edema, and drug-induced edema. Lipedema as a misnomer represents an important differential diagnosis. History and physical examination, when based on a sound knowledge of the diseases of interest, enable a conclusive diagnosis in most cases. Additional test are required in only a minority of patients. The present review discusses pathophysiology and clinical features of the most prevalent types of leg swelling. Finally, a brief guide to differential diagnosis is given.

摘要

腿部肿胀是一种极为常见的症状,其病因多种多样,差异很大。该症状背后最重要的机制包括静脉和淋巴系统病变、容量超负荷、毛细血管通透性增加以及血浆渗透压降低。因此,与腿部肿胀相关的最常见疾病是深静脉血栓形成和慢性静脉功能不全、原发性或继发性淋巴水肿、心力衰竭、肝或肾衰竭导致的低蛋白血症、特发性周期性水肿以及药物性水肿。脂肪性水肿作为一个误称,是一项重要的鉴别诊断。基于对相关疾病的充分了解进行病史采集和体格检查,在大多数情况下能够得出确定性诊断。仅少数患者需要进一步检查。本综述讨论了最常见类型腿部肿胀的病理生理学和临床特征。最后,给出了一份简要的鉴别诊断指南。

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