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子宫颈癌下肢淋巴水肿的治疗现况及进展

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子宫颈癌是妇科恶性肿瘤中常见的疾病,其中广泛性全子宫切除术+盆腔淋巴结清扫术为根治性手术的主要方法,大部分患者需要术后补充放化疗,随访发现部分患者会出现并发症,其中下肢淋巴水肿(lower-limb lymphedema,LLL)为较常见的并发症,临床表现为肢体无痛性肿胀、下肢沉重、紧绷感等症状,严重影响患者的生活质量,增加患者的心理和经济负担。随着医疗水平的进步,子宫颈癌生存率逐渐升高,患者想提高治疗后的生活质量,因此对子宫颈癌术后下肢淋巴水肿的治疗刻不容缓。目前对子宫颈癌下肢淋巴水肿的治疗包括非手术[手法淋巴引流(manual lymph drainage,MLD)综合消肿治疗(complex decongestion therapy,CDT)、中医治疗、电生理]和手术治疗[淋巴管-静脉吻合术(lymph venous anastomosis,LVA)、血管化淋巴结移植术(vascularized lymph node transfer,VLNT)],本文对目前的治疗现况展开叙述。
Current Status and Progress in the Treatment of Lower Limb Lymphedema in Cervical Cancer
Cervical cancer is a common disease in gynecological malignancies,in which extensive total Hysterectomy + pelvic lymph node dissection is the main method of radical surgery.Most patients need postoperative chemotherapy and radiotherapy.Follow up found that some patients will have complications,among which lower limb lymphedema(LLL)is a more common complication,and clinical manifestations are painless swelling of the limbs,heaviness of the lower limbs,and a feeling of tightness,seriously affect the quality of life of patients and increase their psychological and economic burden.With the improvement of medical level,the survival rate of cervical cancer gradually increases,and patients want to improve the quality of life after treatment.Therefore,the treatment of lower limb lymphedema after cervical cancer surgery is urgent.At present,the treatment of lower limb lymphedema of cervical cancer includes non-surgical[manual lymph drainage(MLD)complex decongestion therapy(CDT),traditional Chinese medicine treatment,electrophysiology]and surgical treatment[lymph venous anastomosis(LVA),vascularized lymph node transfer(VLNT)].This article reviews the current status of its treatment.

Cervical cancerLower limb lymphedemaTreatment

汪雨婷、李晓兰

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三峡大学附属第二人民医院(宜昌市第二人民医院) 湖北 宜昌 443000

子宫颈癌 下肢淋巴水肿 治疗

国家卫健委医药卫生科技发展研究中心项目

HDSL202003009

2024

中外医学研究
中国医院管理杂志社

中外医学研究

影响因子:1.149
ISSN:1674-6805
年,卷(期):2024.22(2)
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