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脂肪水肿不是淋巴水肿:对当前文献的综述。

Lipoedema is not lymphoedema: A review of current literature.

机构信息

Division of Dermatology, Department of Medicine, Women's College Hospital, University of Toronto, Toronto, Ontario, Canada.

Department of Dermatology and Allergology, Academic Teaching Hospital Dresden-Friedrichstadt, Dresden, Germany.

出版信息

Int Wound J. 2018 Dec;15(6):921-928. doi: 10.1111/iwj.12949. Epub 2018 Jun 29.

Abstract

Lipoedema is a rare painful disorder of the adipose tissue. It essentially affects females and is often misdiagnosed as lymphoedema or obesity. It is globally misdiagnosed or underdiagnosed, and the literature is lacking appropriate guidance to assist clinicians towards this diagnosis. However, the need to recognise this disorder as a unique entity has important implications to establish proper treatment and, therefore, its tremendous effect on patients. Early diagnosis and treatment can turn these patients' lives upside down. The aim of this review is to focus on the clinical guidance, differential diagnosis, and management strategies. In addition, other aspects of lipoedema, including epidemiology and pathogenesis, are also being discussed here. Lipoedema is distinct from obesity and distinct from lymphoedema, although it might progress to involve the venous and lymphatic system (venolipedema or lympholipedema or both). Late diagnosis can leave the patient debilitated. Management of lipoedema includes weight loss, control of oedema, complex decongestive physiotherapy, liposuction, and laser-assisted lipolysis. However; there are increasing reports on tumescent liposuction as the preferred surgical option with long-lasting results. The role of more randomised controlled studies to further explore the management of this clinical entity remains promising.

摘要

脂肪水肿是一种罕见的疼痛性脂肪组织疾病。它主要影响女性,常被误诊为淋巴水肿或肥胖症。它在全球范围内被误诊或漏诊,文献中缺乏适当的指导来帮助临床医生进行诊断。然而,认识到这种疾病是一种独特的实体具有重要意义,可以为建立适当的治疗方法提供依据,从而减轻对患者的巨大影响。早期诊断和治疗可以彻底改变这些患者的生活。本综述的目的是重点关注临床指导、鉴别诊断和管理策略。此外,还讨论了脂肪水肿的其他方面,包括流行病学和发病机制。脂肪水肿与肥胖症不同,与淋巴水肿也不同,尽管它可能进展为涉及静脉和淋巴系统(静脉脂肪水肿或淋巴脂肪水肿或两者兼有)。晚期诊断会使患者身体虚弱。脂肪水肿的治疗包括减肥、控制水肿、复杂的减压物理疗法、吸脂术和激光辅助脂肪分解术。然而,越来越多的报告称,肿胀吸脂术是一种首选的手术方法,具有持久的效果。需要更多的随机对照研究来进一步探索这种临床实体的治疗方法。

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Brazilian Consensus Statement on Lipedema using the Delphi methodology.采用德尔菲法的巴西脂肪性水肿共识声明。
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本文引用的文献

1
Liposuction in the Treatment of Lipedema: A Longitudinal Study.抽脂术治疗脂肪性水肿:一项纵向研究。
Arch Plast Surg. 2017 Jul;44(4):324-331. doi: 10.5999/aps.2017.44.4.324. Epub 2017 Jul 15.
2
S1 guidelines: Lipedema.S1 指南:脂肪水肿。
J Dtsch Dermatol Ges. 2017 Jul;15(7):758-767. doi: 10.1111/ddg.13036.
4
Approach to Lower Extremity Edema.下肢水肿的处理方法
Curr Treat Options Cardiovasc Med. 2017 Mar;19(3):16. doi: 10.1007/s11936-017-0518-6.
5
Differentiating lipedema and Dercum's disease.鉴别脂肪性水肿和德卡姆病。
Int J Obes (Lond). 2017 Feb;41(2):240-245. doi: 10.1038/ijo.2016.205. Epub 2016 Nov 18.
7
Specialist approaches to managing lipoedema.治疗脂肪性水肿的专业方法。
Br J Community Nurs. 2016 Apr;Suppl:S30-5. doi: 10.12968/bjcn.2016.21.Sup4.S30.

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