| 文 颂,邵株燕,孙海燕,等.数字减影血管造影引导下直接淋巴管造影栓塞术治疗妇科肿瘤术后盆腔淋巴管漏的可行性和安全性[J].肿瘤学杂志,2025,31(4):319-325. |
| 数字减影血管造影引导下直接淋巴管造影栓塞术治疗妇科肿瘤术后盆腔淋巴管漏的可行性和安全性 |
| Feasibility and Safety of Digital Subtraction Angiography Guided Direct Lymphangiography Embolization for Post-Surgical Pelvic Lymphatic Leakage in Patients with Gynecological Tumor |
| 投稿时间：2024-12-23 |
| DOI：10.11735/j.issn.1671-170X.2025.04.B007 |
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| 中文关键词: 妇科肿瘤 淋巴管漏 淋巴管造影 栓塞 碘化油 下肢淋巴水肿 数字减影血管造影 |
| 英文关键词:gynecologic neoplasms lymphatic leakage lymphangiography embolization iodide oil lower limb lymphedema digital subtraction angiography |
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| 中文摘要: |
| 摘 要：［目的］ 探讨在数字减影血管造影（digital subtraction angiography，DSA）引导下直接淋巴管造影栓塞术（direct lymphangiography embolization，DLE）治疗妇科恶性肿瘤术后盆腔淋巴管漏（post-surgical pelvic lymphatic leakage,PSPLL）的临床可行性及安全性。［方法］ 回顾性分析2024年9月至12月期间在浙江省肿瘤医院接受治疗的11例PSPLL患者。患者均有盆腔淋巴管漏，其中1例伴有乳糜胸，均在保守治疗无效后接受DLE治疗。通过超声引导下穿刺腹股沟浅淋巴结，在DSA引导下精确定位盆腔淋巴管漏位置，采用组织生物胶进行淋巴管漏栓塞。观察介入术后1周及1个月的临床疗效和并发症发生情况。［结果］ 11例患者共接受了14次DLE，造影技术成功率达100.0%。介入治疗后，11例患者中9例治愈，1例无效，1例复发，治疗有效率为81.8%（9/11）。11例患者中，9例术前出现腹痛，介入治疗后疼痛轻度缓解4例，中度缓解5例；5例患者出现下肢淋巴水肿，介入术后明显改善1例，轻度改善3例，无效1例。DLE并发症发生率为14.2%，主要为穿刺点轻度疼痛，未见其他严重并发症。［结论］ DSA引导下DLE能够短期内迅速缓解妇科恶性肿瘤PSPLL，并显示出良好的安全性，对于缓解妇科肿瘤PSPLL患者的腹部疼痛及下肢淋巴水肿具有显著疗效，具有临床推广价值。 |
| 英文摘要: |
| Abstract： ［Objective］ To explore the feasibility and safety of digital subtraction angiography (DSA) guided direct lymphangiography embolization (DLE) for post-surgical pelvic lymphatic leakage (PSPLL) in patients with gynecological malignancies. ［Methods］ Clinical data of 11 gynecological cancer patients with PSPLL treated at Zhejiang Cancer Hospital from September to December 2024 were retrospective analyzed， among whom one patient with chylothorax after ineffective conservative treatment. The inguinal superficial lymph nodes puncture was performed under ultrasound guidance， the pelvic lymphatic leakage site was precisely located under DSA guidance， and tissue bio-glue was applied for lymphatic leakage embolization. The clinical efficacy and complications 1 week and 1 month after interventional surgery were observed. ［Results］ A total of 14 DLE procedures were successfully completed in 11 patients. After interventional treatment， 9 were cured， 1 was ineffective， and 1 experienced recurrence with an efficacy rate of 81.8% (9/11). Among 9 patients who experienced abdominal pain， 4 had mild pain relief and 5 had moderate relief after the intervention. In 5 patients with lower limb lymphedema， 1 had significant improvement， 3 had moderate improvement and 1 had no improvement. Mild pain at the puncture site occurred in 2 out of 14 DLE procedures (14.2%)， there was no other serious complications observed. ［Conclusion］ DSA-guided DLE can rapidly alleviate PSPLL in patients with gynecological tumor surgery， with good safety and efficiency and without serious complications， which is worth of clinical promotion. |
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