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Towards an effective management of chronic lymphedema

机译:努力有效治疗慢性淋巴水肿

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Lymph conduit perturbation causes lymph stasis and the local accumulation of interstitial fluid. Lymphedema, a chronic and debilitating disorder, remains incurable despite the advances in the description of its pathomechanism and the improvement of conservative and nonsurgical treatments. The gold standard of lymphedema treatment is multicomponent decongestive physiotherapy. Manual lymph drainage, compression bandaging, skin care, and exercises constitute the therapeutic regimen that could be adjusted with intermittent pneumatic compression. Prophylaxis could give a major benefit to risk group patients; however, the assessment of preventive approaches postulates further clinical trials. Surgery represents an emerging stakeholder in lymphedema care, although, the partnership with adjunctive nonsurgical therapy is still alive. Liposuction proved to be one of the most promising technique with the clearance of the lymph stasis-related adipose tissue. Regeneration of lymphatic tunnels with lymphovenous anastomoses or the transplantation of lymph vessels or small veins is based on long-term experience. The success of lymph node transplantation is still under evaluation, but this novel technique has produced notable improvements.
机译:淋巴管微扰导致淋巴淤滞和间质液的局部积聚。淋巴水肿是一种慢性和使人衰弱的疾病,尽管对其致病机理的描述有所进步,并且保守治疗和非手术治疗有所改善,但仍无法治愈。淋巴水肿治疗的金标准是多成分减充血理疗。手动淋巴引流,加压包扎,皮肤护理和锻炼构成了可以通过间歇性气动加压进行调整的治疗方案。预防可能会给高危人群带来重大好处。然而,对预防方法的评估假定了进一步的临床试验。外科手术代表着淋巴水肿护理领域的新兴利益相关者,尽管与辅助性非手术疗法的伙伴关系仍然存在。抽脂被证明是清除淋巴淤积相关脂肪组织的最有前途的技术之一。淋巴管吻合与淋巴管的再生或淋巴管或小静脉的移植是基于长期的经验。淋巴结移植的成功与否仍在评估中,但这项新技术已取得显着进步。

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