小结
定义
病史和体格检查
关键诊断因素
- 恶性肿瘤史
- 丝虫病流行区旅行史
- 既往手术史
- 放疗史
- 肢体或生殖器单侧无痛性肿胀
- 肢体远端受累
- Stemmer征阳性
其他诊断因素
- 腋窝或腹股沟穿透伤病史
- 肢体沉重和/或无力
- 非凹陷性水肿
- 皮肤改变
- 淋巴水肿家族史
危险因素
- 乳腺癌的治疗
- 线虫感染（丝虫病）
- 腋窝或腹股沟淋巴结附近的外科手术
- 晚期肿瘤、淋巴结和转移（TNM）分期
- 放射治疗
- 创伤
- 曲线瘢痕
- 淋巴水肿家族史
- 遗传性综合征
- 肥胖
诊断性检查
首要检查
- 核素淋巴显像
需考虑的检查
- 患肢的MRI扫描
- 患肢的CT扫描
- 受累部位超声检查
- 淋巴管造影
- 丝虫病血涂片检查
- 基因检测
治疗流程
所有患者
撰稿人
作者
Reid A. Maclellan, MD, MMSc
Department of Plastic and Reconstructive Surgery
Instructor of Surgery
Children’s Hospital Boston
Harvard Medical School
Boston
MA
利益声明
RAM is an author of a number of references cited in this topic.
Arin K. Greene, MD, MMSc
Department of Plastic and Oral Surgery
Boston Children's Hospital
Director Lymphedema Program
Vascular Anomalies and Pediatric Plastic Surgery Endowed Chair
Professor of Surgery
Harvard Medical School
Boston
MA
利益声明
AKG has received royalties from Springer Publishing as Editor of a lymphoedema textbook. AKG is an author of a number of references cited in this topic.
鸣谢
Dr Reid A. Maclellan and Dr Arin K. Greene would like to gratefully acknowledge Dr Sumner A. Slavin and Dr Carolyn C. Schook, previous contributors to this topic.
利益声明
SAS and CCS are authors of a number of references cited in this topic.
同行评议者
Hakan Brorson, MD, PhD
Senior Consultant Plastic Surgeon
Department of Plastic and Reconstructive Surgery
Lund University
Malmoe University Hospital
Malmoe
Sweden
利益声明
HB is an author of a number of references cited in this topic.
Neil R. Feins, MD
Professor
Harvard Medical School
Senior Surgeon
Children's Hospital Boston
Boston
MA
利益声明
NRF declares that he has no competing interests.
鉴别诊断
- 慢性静脉功能不全
- 深静脉血栓形成（DVT）
- 脂肪水肿
更多 鉴别诊断指南
- 外周淋巴水肿的诊断与治疗
- 管理淋巴水肿的最佳实践：一项国际共识
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