28例马德龙病的临床分析

Clinical analysis of 28 cases of Madelung’s disease

目的探讨马德龙病(MD)的临床特征、治疗方式及预后情况。方法回顾性分析2013-2023年西南医科大学附属医院收治的28例MD患者的临床资料,总结其人口统计学特征、临床指标、脂肪沉积部位、治疗方式及预后情况。结果28例MD患者中,男26例,女2例;年龄27~68岁,平均年龄51.11岁。所有患者根据Enzi分型均为Ⅰ型MD;24例(85.71%)患者既往有长期饮酒史,19例(67.86%)患者有吸烟史;23例(82.14%)脂肪沉积部位主要位于颈前区;24例患者接受手术治疗,2例因术后并发症死亡。术后随访1~110个月,失访3例,复发8例,死亡2例;1、2、3年复发率分别为31.59%、42.11%、42.11%,其中复发患者中,术后继续饮酒者所占比例高达87.50%。结论MD主要发生在长期饮酒的中年男性,Ⅰ型MD为其主要类型。MD常见的脂肪沉积部位在颈前区,开放性手术切除沉积脂肪仍是其主要治疗方式。术后继续饮酒是影响MD复发的独立危险因素。

Objective To investigate the clinical features,treatment and prognosis of Madelung’s disease(MD).Methods Clinical data of 28 MD patients admitted to the Affiliated Hospital of Southwest Medical University from 2013 to 2023 were retrospectively analyzed,and their demographic characteristics,clinical indexes,fat deposition sites,treatment methods and prognosis were summarized.Results Of the 28 patients with MD,26 were male and 2 were female,aged from 27 to 68 years with an average age of 51.11.All patients were classified as type I MD according to Enzi’s typing system.Of all the patients,85.71%had a long history of drinking alcohol,67.86%had a history of smoking,and 82.14%fat deposits were mainly located in the anterior cervical region.Twenty-four patients received surgical treatment,and two died due to postoperative complications.After 1 to 110 months of postoperative follow-up,3 cases were lost to follow-up,8 cases recurred and 2 cases died.The recurrence rates at 1,2 and 3 years were 31.59%,42.11%and 42.11%,respectively.Among the patients with recurrence,87.50%continued to drink after surgery.Conclusion MD occurs mainly in middle-aged men who have been drinking alcohol for a long time,and the main type of MD is type I.The most common site of fat deposition in MD is the anterior neck region.Open surgery to remove the fat deposits remains the main treatment modality.Continued postoperative alcohol consumption is an independent risk factor for recurrence of MD.