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下肢淋巴静脉吻合联合吸脂术后应用完整消肿疗法的回顾性研究。

Application of complete decongestive therapy after lymphaticovenular anastomosis of the lower limb combined with liposuction-A retrospective study research.

机构信息

Department of Burn, Plastic and Cosmetic Surgery, Xi'an Central Hospital, Xi'an Jiaotong University, Xi'an, China.

出版信息

Phlebology. 2024 Feb;39(1):49-57. doi: 10.1177/02683555231209056. Epub 2023 Oct 28.

Abstract

BACKGROUND

Complete decongestive therapy (CDT) is a conservative treatment for lymphedema that combines interventions and lifestyle changes. We evaluated the application of CDT after lymphaticovenular anastomosis (LVA) of the lower limb combined with liposuction.

METHODS

A total of 55 patients who underwent LVA of the lower limb combined with liposuction from January 2021 to July 2022 were enrolled in the study. The patients were divided into groups A ( = 24) and B ( = 31) according to whether they adhered to CDT treatment during the 12-month follow-up. Group A was the non-adherence CDT group and Group B was the adherence CDT group. Lower Extremity Lymphedema Index (LELI) and Lymphoedema Functioning, Disability, and Health Questionnaire for Lower Limb Lymphoedema (Lymph-ICF-LL) were used as prognostic indicators to observe the remission of postoperative lymphedema symptoms in the two groups.

RESULTS

At 6-month and 12-month follow-up, LELI and the score of Lymph-ICF-LL in group B and group A were lower than before the operation ( < .05). The circumference of the affected limb was reduced, and the quality of life was improved in both groups after the operation. The reduction of LELI and Lymph-ICF-LL in group B was higher than in group A, and the difference was statistically significant ( < .05).

CONCLUSION

This study preliminarily proves the effectiveness of CDT after LVA of the lower limb combined with liposuction, which can maintain and strengthen the surgical effect. Further, CDT treatment is still needed after the operation, which is necessary to reduce the circumference of the affected limb and improve patients' quality of life.

摘要

背景

完整消肿疗法(CDT)是一种联合干预和生活方式改变的保守治疗淋巴水肿的方法。我们评估了下肢淋巴静脉吻合术(LVA)联合吸脂术后应用 CDT 的效果。

方法

2021 年 1 月至 2022 年 7 月,共纳入 55 例行下肢 LVA 联合吸脂术的患者,根据术后 12 个月是否坚持 CDT 治疗将患者分为 A 组(n = 24)和 B 组(n = 31)。A 组为不坚持 CDT 治疗组,B 组为坚持 CDT 治疗组。下肢淋巴水肿指数(LELI)和淋巴水肿功能、残疾和下肢淋巴水肿健康问卷(Lymph-ICF-LL)作为预后指标,观察两组术后淋巴水肿症状的缓解情况。

结果

术后 6 个月和 12 个月随访时,B 组和 A 组的 LELI 和 Lymph-ICF-LL 评分均低于术前(<0.05)。两组术后肢体周径减小,生活质量均提高。B 组 LELI 和 Lymph-ICF-LL 的降低程度均高于 A 组,差异有统计学意义(<0.05)。

结论

本研究初步证明了 LVA 联合吸脂术后应用 CDT 的有效性,能维持和加强手术效果。此外,术后仍需进行 CDT 治疗,以减小患侧肢体周径,提高患者生活质量。

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