Whitnell Lori A
AORN J. 2020 Feb;111(2):187-198. doi: 10.1002/aorn.12924.
Lymphedema-the accumulation of fluid in tissues, usually in the upper and lower extremities-often results from lymph node dissection or radiation and can cause painful and debilitating swelling that may interfere with a patient's daily living activities and quality of life. The goal of treatment for lymphedema is to reduce the volume of fluid in the affected area. Lymphedema is staged according to presenting characteristics, and interventions may be surgical or nonsurgical, such as complex decongestive therapy. Lymphovenous bypass is a surgical procedure performed for the management of lymphedema and involves rerouting microvascular channels to allow for the drainage of fluid that has accumulated in the lymphatic tissue of the upper or lower extremities. It requires supermicrosurgery techniques because of the small size of the vessels being anastomosed. Perioperative nursing implications for lymphovenous bypass include OR preparation and providing emotional support for patients living with lymphedema.
淋巴水肿——通常在上下肢组织中液体的积聚——常由淋巴结清扫或放疗引起，可导致疼痛且使人虚弱的肿胀，这可能会干扰患者的日常生活活动和生活质量。淋巴水肿的治疗目标是减少受影响区域的液体量。淋巴水肿根据呈现的特征进行分期，干预措施可能是手术的或非手术的，如综合消肿治疗。淋巴静脉旁路术是一种用于治疗淋巴水肿的外科手术，涉及重新规划微血管通道，以使积聚在上肢或下肢淋巴组织中的液体得以引流。由于吻合的血管尺寸小，该手术需要超显微外科技术。淋巴静脉旁路术的围手术期护理要点包括手术室准备以及为淋巴水肿患者提供情感支持。
