Ratchford Elizabeth V, Evans Natalie S
Johns Hopkins Center for Vascular Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Section of Vascular Medicine, Cleveland Clinic, Cleveland, OH, USA.
Curr Treat Options Cardiovasc Med. 2017 Mar;19(3):16. doi: 10.1007/s11936-017-0518-6.
Lower extremity edema is extremely common among patients seen across multiple specialties. The differential diagnosis is broad and ranges from simple dependent edema to more complex conditions such as chronic venous disease and lymphedema. Several key features from the history and physical exam can assist with the diagnosis. Imaging is rarely necessary at the initial visit unless venous thromboembolism is suspected. Treatment is specific to the etiology of the edema, but compression stockings, elevation, exercise, and weight loss remain the cornerstone in most cases.
下肢水肿在多个专科就诊的患者中极为常见。鉴别诊断范围广泛，从单纯的下垂性水肿到更复杂的疾病，如慢性静脉疾病和淋巴水肿。病史和体格检查中的几个关键特征有助于诊断。除非怀疑有静脉血栓栓塞，初诊时很少需要影像学检查。治疗针对水肿的病因，但在大多数情况下，压力袜、抬高下肢、运动和减肥仍是基础治疗方法。
