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目的 探讨带瓣膜的静脉移植手术对乳腺癌根治术后上肢淋巴水肿的治疗作用。方法 9例乳腺癌根治术后上肢淋巴水肿患者 ,进行了移植下肢大隐静脉及其属支桥接代替淋巴管 ,远端与上肢淋巴管吻合 ,近端与颈外静脉或者头静脉吻合。结果 术后上肢淋巴水肿消退显著 ,表现为 :周径减小和体积缩小 ,5例优良 ,3例良好 ,1例改善 ;随访 3～ 2 1个月 ,疗效稳定。结论 带瓣膜的静脉移植代替淋巴管对乳腺癌术后上肢淋巴水肿有显著治疗作用 ,可能为其治疗提供了一新的途径
Objective To investigate the effect of vein graft with valve on the treatment of upper limb lymphedema after radical mastectomy. Methods Nine patients with upper limb lymphedema after radical mastectomy underwent transplantation of the inferior saphenous vein and its genus branch bridge instead of lymphatic vessels. The distal end was anastomosed with the upper limb lymphatic vessel and the proximal end was anastomosed with the external jugular vein or cephalic vein. Results Postoperative lymphedema of the upper extremity subsided significantly, manifested as: decreased diameter and reduced size, 5 cases were excellent, 3 cases were good, 1 case improved; follow-up 3 to 21 months, the curative effect was stable. [Conclusion] The replacement of lymphatic vessels with valved veins has significant therapeutic effect on upper limb lymphedema after breast cancer surgery and may provide a new approach for its treatment.