Smeltzer D M, Stickler G B, Schirger A
Pediatrics. 1985 Aug;76(2):206-18.
Primary lymphedema, a disorder causing persistent swelling in an extremity, is rare in children and adolescents; it affects 1.15/100,000 persons less than age 20 years. It primarily affects girls near menarche. The records of 125 children and adolescents, aged 0 to 20 years, who were examined at the Mayo Clinic were analyzed; 99 of these patients were contacted to obtain follow-up data. The influences of estrogen and inflammation are thought to be important etiologic factors in primary lymphedema. The diagnosis can be made on the basis of a thorough history and physical examination. Lymphangiograms, venograms, and biopsies add nothing to the diagnosis because of the low incidence of tumor in children and adolescents. Conservative treatment is recommended: a Jobst-type stocking, elevation, and proper foot care. Diuretics are not recommended. Careful psychologic counseling, especially in adolescents, is highly recommended.
原发性淋巴水肿是一种导致肢体持续性肿胀的疾病，在儿童和青少年中较为罕见；在20岁以下人群中的发病率为1.15/10万。它主要影响初潮前后的女孩。对梅奥诊所检查的125名0至20岁儿童和青少年的记录进行了分析；其中99名患者被联系以获取随访数据。雌激素和炎症被认为是原发性淋巴水肿的重要病因。诊断可基于详尽的病史和体格检查做出。由于儿童和青少年肿瘤发病率低，淋巴管造影、静脉造影和活检对诊断并无帮助。建议采用保守治疗：使用乔斯特（Jobst）型弹力袜、抬高患肢以及适当的足部护理。不建议使用利尿剂。强烈建议进行仔细的心理辅导，尤其是对青少年。
