王雷永 1 , 李曉廣 1 , 朱巖 1 , 霍小森 1 , 季鋒 1 , 李震 1 , 汪忠鎬 1,2
  • 1.航空總醫(yī)院血管外科（北京 100012）;;
  • 2.首都醫(yī)科大學(xué)血管外科研究所（北京 100053）;

目的探討改良的局部加壓包扎法治療腹股溝區(qū)切口淋巴瘺的療效。方法2005年12月至2010年11月期間對(duì)10例腹股溝區(qū)切口淋巴瘺患者采用彈力繃帶持續(xù)加壓包扎，同時(shí)切口放置閉式引流裝置進(jìn)行治療。 結(jié)果全部患者切口經(jīng)加壓包扎后淋巴液均明顯減少，經(jīng)持續(xù)加壓包扎3~20 d（平均7.2 d）后獲臨床治愈; 其中1例患者于加壓包扎后第4天出現(xiàn)下肢股淺靜脈血栓，經(jīng)及時(shí)溶栓和抗凝治療后好轉(zhuǎn)。 本組患者隨訪1~59個(gè)月（平均14.7個(gè)月），10例患者切口均一期愈合，無下肢淋巴水腫發(fā)生。結(jié)論彈力繃帶加壓包扎結(jié)合切口閉式引流治療腹股溝區(qū)切口淋巴瘺療效顯著，該方法簡(jiǎn)單、安全，值得臨床推廣應(yīng)用。

引用本文： 王雷永,李曉廣,朱巖,霍小森,季鋒,李震,汪忠鎬. 彈力繃帶加壓包扎結(jié)合切口閉式引流在腹股溝區(qū)淋巴瘺治療中的應(yīng)用. 中國(guó)普外基礎(chǔ)與臨床雜志, 2011, 18(9): 997-998. doi: 復(fù)制

1. 陸信武, 蔣米爾. 血管手術(shù)后腹股溝部淋巴瘺的原因和防治 [J]. 外科理論與實(shí)踐, 2002, 7(3): 218220.
2. Tyndall SH, Shepard AD, Wilczewski JM, et al. Groin lymphatic complications after arterial reconstruction [J]. J Vasc Surg, 1994， 19(5): 858864.
3. Pedersen G, Laxdal E, Hagala M, et al. Local infections after aboveknee prosthetic femoropopliteal bypass for intermittent claudication [J]. Surg Infect (Larchmt), 2004， 5(2): 174179.
4. Ploeg AJ, Lardenoye JW, Peeters MP, et al. Wound complications at the groin after peripheral arterial surgery sparing the lymphatic tissue: a doubleblind randomized clinical trial [J]. Am J Surg, 2009, 197(6): 747751.
5. 陳中皓, 龔亦群, 呂杰捷. 纖維蛋白封閉劑預(yù)防血管外科手術(shù)并發(fā)腹股溝淋巴瘺的回顧性分析 [J]. 上海醫(yī)藥, 2004, 25(8): 361362.
6. 周興立, 陳翠菊, 郭曙光, 等. 超聲消融治療下肢深靜脈血栓形成及術(shù)后并發(fā)腹股溝部淋巴瘺原因探討 [J]. 中國(guó)普通外科雜志, 2004, 13(1): 911.
7. 鄭曉兵, 冉峰, 劉長(zhǎng)建. 泛影葡胺膠緩釋劑預(yù)防腹股溝區(qū)血管手術(shù)后切口淋巴瘺 [J]. 第二軍醫(yī)大學(xué)學(xué)報(bào), 2007, 28(9): 10241025.
8. 劉丹, 方海龍, 劉華. 大隱靜脈高位結(jié)扎及剝脫術(shù)后腹股溝切口淋巴瘺臨床分析及文獻(xiàn)回顧 [J]. 中國(guó)普外基礎(chǔ)與臨床雜志, 2010, 17(12): 13121313.
9. Hackert T, Werner J, Loos M, et al. Successful doxycycline treatment of lymphatic fistulas: report of five cases and review of literature [J]. Langebecks Arch Surg, 2006, 391(4): 435438.
10. 劉靜, 鄒耀強(qiáng), 周天保. 3例大隱靜脈曲張術(shù)后淋巴漏的診治體會(huì) [J]. 中國(guó)普外基礎(chǔ)與臨床雜志, 2002, 9(4): 271.
11. Hamed O, Muck PE, Smith JM, et al. Use of vacuumassisted closure (VAC) therapy in treating lymphatic complications after vascular procedures: new approach for lymphoceles [J]. J Vasc Surg, 2008, 48(6): 15201523.
12. Lemaire V, Brilmaker J, Kerzmann A, et al. Treatment of a groin lymphatic fistula with negative pressure wound therapy [J]. Eur J Vasc Endovasc Surg, 2008, 36(4): 449451.
13. Abai B, Zickler RW, Pappas PJ, et al. Lymphorrhea responds to negative pressure wound therapy [J]. J Vasc Surg, 2007, 45(3): 610613.
14. Argenta LC, Morykwas MJ, Marks MW, et al. Vacuumassisted closure: state of clinic art [J]. Plast Reconstr Surg, 2006, 117(7 Suppl): 127S142S.
15. Steenvoorde P, Slotema E, Adhin S, et al. Deep infection after ilioinguinal node dissection: vacuumassisted closure therapy? [J]. Int J Low Extrem Wounds, 2004, 3(4): 223226.
  1. 1. 陸信武, 蔣米爾. 血管手術(shù)后腹股溝部淋巴瘺的原因和防治 [J]. 外科理論與實(shí)踐, 2002, 7(3): 218220.
  2. 2. Tyndall SH, Shepard AD, Wilczewski JM, et al. Groin lymphatic complications after arterial reconstruction [J]. J Vasc Surg, 1994， 19(5): 858864.
  3. 3. Pedersen G, Laxdal E, Hagala M, et al. Local infections after aboveknee prosthetic femoropopliteal bypass for intermittent claudication [J]. Surg Infect (Larchmt), 2004， 5(2): 174179.
  4. 4. Ploeg AJ, Lardenoye JW, Peeters MP, et al. Wound complications at the groin after peripheral arterial surgery sparing the lymphatic tissue: a doubleblind randomized clinical trial [J]. Am J Surg, 2009, 197(6): 747751.
  5. 5. 陳中皓, 龔亦群, 呂杰捷. 纖維蛋白封閉劑預(yù)防血管外科手術(shù)并發(fā)腹股溝淋巴瘺的回顧性分析 [J]. 上海醫(yī)藥, 2004, 25(8): 361362.
  6. 6. 周興立, 陳翠菊, 郭曙光, 等. 超聲消融治療下肢深靜脈血栓形成及術(shù)后并發(fā)腹股溝部淋巴瘺原因探討 [J]. 中國(guó)普通外科雜志, 2004, 13(1): 911.
  7. 7. 鄭曉兵, 冉峰, 劉長(zhǎng)建. 泛影葡胺膠緩釋劑預(yù)防腹股溝區(qū)血管手術(shù)后切口淋巴瘺 [J]. 第二軍醫(yī)大學(xué)學(xué)報(bào), 2007, 28(9): 10241025.
  8. 8. 劉丹, 方海龍, 劉華. 大隱靜脈高位結(jié)扎及剝脫術(shù)后腹股溝切口淋巴瘺臨床分析及文獻(xiàn)回顧 [J]. 中國(guó)普外基礎(chǔ)與臨床雜志, 2010, 17(12): 13121313.
  9. 9. Hackert T, Werner J, Loos M, et al. Successful doxycycline treatment of lymphatic fistulas: report of five cases and review of literature [J]. Langebecks Arch Surg, 2006, 391(4): 435438.
  10. 10. 劉靜, 鄒耀強(qiáng), 周天保. 3例大隱靜脈曲張術(shù)后淋巴漏的診治體會(huì) [J]. 中國(guó)普外基礎(chǔ)與臨床雜志, 2002, 9(4): 271.
  11. 11. Hamed O, Muck PE, Smith JM, et al. Use of vacuumassisted closure (VAC) therapy in treating lymphatic complications after vascular procedures: new approach for lymphoceles [J]. J Vasc Surg, 2008, 48(6): 15201523.
  12. 12. Lemaire V, Brilmaker J, Kerzmann A, et al. Treatment of a groin lymphatic fistula with negative pressure wound therapy [J]. Eur J Vasc Endovasc Surg, 2008, 36(4): 449451.
  13. 13. Abai B, Zickler RW, Pappas PJ, et al. Lymphorrhea responds to negative pressure wound therapy [J]. J Vasc Surg, 2007, 45(3): 610613.
  14. 14. Argenta LC, Morykwas MJ, Marks MW, et al. Vacuumassisted closure: state of clinic art [J]. Plast Reconstr Surg, 2006, 117(7 Suppl): 127S142S.
  15. 15. Steenvoorde P, Slotema E, Adhin S, et al. Deep infection after ilioinguinal node dissection: vacuumassisted closure therapy? [J]. Int J Low Extrem Wounds, 2004, 3(4): 223226.