Application of Cohesive Compression Bandage Enswathement Combined Closed Drainage via Wound on Treatment for Groin Lymphatic Fistula_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

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

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Keywords：

腹股溝; 淋巴瘺; 加壓包扎療法; 并發癥

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目的探討改良的局部加壓包扎法治療腹股溝區切口淋巴瘺的療效。方法2005年12月至2010年11月期間對10例腹股溝區切口淋巴瘺患者采用彈力繃帶持續加壓包扎，同時切口放置閉式引流裝置進行治療。結果全部患者切口經加壓包扎后淋巴液均明顯減少，經持續加壓包扎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天出現下肢股淺靜脈血栓，經及時溶栓和抗凝治療后好轉。本組患者隨訪1~59個月（平均14.7個月），10例患者切口均一期愈合，無下肢淋巴水腫發生。結論彈力繃帶加壓包扎結合切口閉式引流治療腹股溝區切口淋巴瘺療效顯著，該方法簡單、安全，值得臨床推廣應用。

Citation： 王雷永,李曉廣,朱巖,霍小森,季鋒,李震,汪忠鎬. Application of Cohesive Compression Bandage Enswathement Combined Closed Drainage via Wound on Treatment for Groin Lymphatic Fistula. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2011, 18(9): 997-998. doi: Copy

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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. 纖維蛋白封閉劑預防血管外科手術并發腹股溝淋巴瘺的回顧性分析 [J]. 上海醫藥, 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后并發腹股溝部淋巴瘺原因探討 [J]. 中國普通外科雜志, 2004, 13(1): 911.
7.	鄭曉兵, 冉峰, 劉長建. 泛影葡胺膠緩釋劑預防腹股溝區血管手術后切口淋巴瘺 [J]. 第二軍醫大學學報, 2007, 28(9): 10241025.
8.	劉丹, 方海龍, 劉華. 大隱靜脈高位結扎及剝脫術后腹股溝切口淋巴瘺臨床分析及文獻回顧 [J]. 中國普外基礎與臨床雜志, 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, 周天保. 3例大隱靜脈曲張術后淋巴漏的診治體會 [J]. 中國普外基礎與臨床雜志, 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. 陸信武, 蔣米爾. 血管手術后腹股溝部淋巴瘺的原因和防治 [J]. 外科理論與實踐, 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. 纖維蛋白封閉劑預防血管外科手術并發腹股溝淋巴瘺的回顧性分析 [J]. 上海醫藥, 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后并發腹股溝部淋巴瘺原因探討 [J]. 中國普通外科雜志, 2004, 13(1): 911.
7. 鄭曉兵, 冉峰, 劉長建. 泛影葡胺膠緩釋劑預防腹股溝區血管手術后切口淋巴瘺 [J]. 第二軍醫大學學報, 2007, 28(9): 10241025.
8. 劉丹, 方海龍, 劉華. 大隱靜脈高位結扎及剝脫術后腹股溝切口淋巴瘺臨床分析及文獻回顧 [J]. 中國普外基礎與臨床雜志, 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, 周天保. 3例大隱靜脈曲張術后淋巴漏的診治體會 [J]. 中國普外基礎與臨床雜志, 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.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Application of Cohesive Compression Bandage Enswathement Combined Closed Drainage via Wound on Treatment for Groin Lymphatic Fistula

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