负压抽吸法治疗肢体淋巴水肿的远期疗效分析

The Long Term Efficacy of the Pure Liposuction Treatment for Patiens with Limb Lymphoedema

目的：分析应用负压抽吸法治疗四肢淋巴水肿的远期疗效结果。方法：自1999年2月开始应用单纯负压抽吸法治疗四肢淋巴水肿，采用问卷方式对疗效进行分析，发出问卷45份，回复问卷17份。其中上肢淋巴水肿7例．下肢淋巴水肿10例。对肢体周径的变化以及丹毒控制的治疗效果加以调查。结果：平均随访时间4.63年。术后肢体的周径明显缩小，应用弹性绷带或弹力袜加压包扎，维持3～12个月，平均维持6个月左右，之后恢复到术前水平。丹毒发作术前平均每年3.41次，抽吸术后丹毒发作消失，平均约2.21年后丹毒发作开始出现。患者满意率67.66％，不满意的原因主要是对肢体肿胀控制的维持时间较短，以及弹力套使用不方便。结论：应用抽吸法可以有效地控制丹毒发作，一段时间内可以减轻肢体肿胀，改善外形。对于具有部分淋巴回流功能的轻中度肢体淋巴水肿患者抽吸法是可供选择的有效治疗方法。

Objective：The aim of this study was to investigate the long term results of lymphoedema treated with pure liposuction. Methods：We started the treatment of limb lymphoedema with liposuction in 1999. Fourty-five questionnaires were posted out with 17 forms returned. There were 7 upper limb edemas and 10 lower limb lymphoedemas. The control of the limb reduc- tion and lymphetitis were investigated. Results：The mean follow-up time was 4.63 years. There were no major complications. Substantial limb volume reduction was archived in all cases immediately after operation. The reduction remained 3 to 12 months, with average of 6.01 months. Then it returned to the level before operation. The lymphetitis completely disappeared about 2.21 years after operation, and returned slowly. The satisfactory rate was 67.66%. The main reasons of dissatisfaction were the short term control of limb edema, and the inconvenient usage of compression garment. Conclusion：We conclude that liposuction can control lymphetitis effectively. It reduces the limb edema for a short time. It is an effective method to treat the limb lymphoedema of those patients with partial lympho-drainage fuction.