应用皮瓣桥接治疗阴囊及下肢淋巴水肿的疗效观察

Use of flap bridging in the treatment of lymphedema of scrotum and lower extremities

目的 探讨皮瓣桥接法治疗淋巴水肿的疗效。 方法 对 8例阴囊及下肢淋巴水肿所致严重皮肤病变应用轴型皮瓣和任意型皮瓣 (胸腹联合皮管 )治疗。切除病变组织、移转皮瓣、桥接引流淋巴液。 结果 2年～ 7年术后随访观察 ,除 1例外伤性小腿淋巴水肿术后 3年复发外 ,其余各例淋巴水肿病变部位术后 6月～ 12月逐渐显效 ,患肢肿胀均有不同程度的减轻且病情稳定 ,无丹毒及蜂窝织炎再发 ,手术效果满意。 结论 利用皮瓣修复淋巴水肿所致的严重皮肤病变部位是治疗淋巴水肿的一种有效方法。

Objective To summarize the curative effect of flap bridging for lymphedema. Methods The axial flap and the random tube flap (joining the chest and abdomen) were used to treat 8 cases of lymphedema on scrotum and legs resulting in serious pathological changes of skin.The lesions were excised, flaps transferred and bridged, and then lymph fluid drained. Results Follow-up observations for 2～7 years showed recurrence in 1 case of traumatic shank lymphedema 3 years after operation.The remaining patients became gradually improved in 6～12 months postoperatively, lymphedema of the lower extremities getting alleviated at varying degrees, without recurrence of erysipelas or phlegmon. Conclusions Application of flap technique for serious pathological changes of skin caused by lymphedema is effective.