淋巴结吻合成功治疗类风湿性淋巴水肿1例

Y. Ichinose, Y. Yasunaga, S. Yuzuriha
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引用次数: 1

摘要

摘要背景一名76岁女性在患类风湿关节炎(RA) 20年后出现左肘远端类风湿淋巴水肿(RL)。虽然药物控制了RA,但由于长期RA引起的手部功能障碍,患者无法接受中压压套(压力:20-25 mm Hg)对其水肿的全面压迫治疗。方法采用低压套筒(14 ~ 18 mm Hg)加压治疗,对水肿缓解无效后,行淋巴小囊吻合。在肘窝处以侧对端方式创建两个吻合口。结果LVA术后水肿迅速改善,采用低压压套维持。结论LVA是RA治疗中剩余RL的一种治疗选择。由于一些RL患者由于RA引起的手部功能障碍而不适合进行全面的压迫治疗,LVA可能有助于减少RL并使用低压压迫服进行水肿管理,而无需担心手部功能障碍。
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Rheumatoid Lymphedema Successfully Treated with Lymphaticovenular Anastomosis: A Case Report
Abstract Background A 76-year-old woman presented with rheumatoid lymphedema (RL) distal to the left elbow after 20 years of affliction with rheumatoid arthritis (RA). Although the RA was controlled by medication, the patient could not receive full-scale compression therapy for her edema with a medium-pressure compression sleeve (pressure: 20–25 mm Hg) due to hand dysfunction caused by long-term RA. Methods Lymphaticovenular anastomosis (LVA) was performed after compression therapy with a low-pressure sleeve (14–18 mm Hg) proved ineffective for edema relief. Two anastomoses were created in a side-to-end fashion at the cubital fossa. Results The edema improved rapidly after LVA and was maintained with a low-pressure compression sleeve. Conclusion LVA represents a treatment option for remaining RL in RA treatment. As some RL patients are ineligible for full-scale compression therapy due to hand dysfunction caused by RA, LVA may help to reduce RL and enable edema management using a low-pressure compression garment without concern for hand dysfunction.
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