小儿先天性淋巴水肿48例诊治体会

Congenital Lymphadema: a Report of 48 Cases

目的:通过病例分析,研究先天性淋巴水肿几种治疗方法的优劣与指征。方法:复习48例先天性淋巴水肿,其中3例术前核素淋巴显像确诊。本组8例行真皮瓣埋藏术,37例行病变切除加游离植皮,1例行淋巴静脉吻合术,2例未手术。结果:8例行真皮瓣埋藏术者6例效果满意,37例行病变切除加游离植皮者效果均满意。结论:核素淋巴显像是一种诊断淋巴水肿的可靠客观方法。本病较轻者行真皮瓣埋藏术效果较好,较重者宜行病变切除加自体植皮术。而淋巴静脉吻合术技术困难且对先天性淋巴水肿效果欠佳。

Objective:To compare the different approaches of surgical treatment of congenital lymphadema.Methods:Forty-eight cases of congenital lymphadema were reviewed.Of them,3 cases had Tc 99 isotope lymphangiogram preoperatively.Results:Forty-six patients underwent surgical intervention and were followed-up for 1 to 17 years.The outcome of 6 out of 8 cases re- ceived Swiss-roll operation were satisfactory.Thirty-seven children who underwent excision and skin autograft had satisfactory results.Conclusions:Tc 99 isotope lymphangiogram is a reliable investigation of congenital lymphadema.Swiss-roll operation results in satisfactory outcome in moderately severe cases whereas excision and skin autograft are more applicable in severe cases. Lymphovenous anastomosis is not ideal for children.