肿瘤相关淋巴水肿的临床实践指导意见:基于德尔菲法的中国专家共识(2025年版)

Clinical Practice Guidelines for Tumor-related Lymphedema: Chinese Expert Consensus Based on the Delphi Method (2025 Version)

  • 摘要: 肿瘤相关淋巴水肿是恶性肿瘤及癌症相关治疗后并发的一种常见慢性进行性淋巴系统疾病,临床表现为患肢肿胀、沉重、僵硬、活动障碍等不适,可致残并引发焦虑、抑郁等情绪障碍,严重影响患者的生活质量。该病的管理是一项长期任务并依赖多学科协作,尽管国内已有相关共识发表,但其内容尚欠全面,导致临床实践仍缺乏统一、规范的指导,亟待更新并制定更全面的本土化文件。来自中国17个省、直辖市或自治区的30位专家,基于最新循证医学证据,采用德尔菲法共同制订了《肿瘤相关淋巴水肿的临床实践指导意见:基于德尔菲法的中国专家共识(2025年版)》。该共识围绕肿瘤相关淋巴水肿的风险因素、监测随访、患者教育、诊断评估、综合消肿治疗、药物治疗、手术治疗、营养管理及多学科管理9个关键维度,最终达成113项共识建议,为肿瘤相关淋巴水肿的临床实践提供了规范化指导意见。

     

    Abstract: Tumor-related lymphedema is a common chronic progressive lymphatic disorder that occurs as a complication of malignant tumors and cancer-related therapy. It clinically presents with symptoms such as swelling, heaviness, stiffness and impaired mobility of the affected limb. The condition can lead to disability and trigger emotional disturbances such as anxiety and depression, significantly impairing patients' quality of life. The management of this disease is a long-term endeavor that relies on multidisciplinary collaboration. Although relevant consensus documents have been published domestically, their content remains insufficiently comprehensive, resulting in a lack of unified and standardized guidance in clinical practice. There is an urgent need to update and develop more comprehensive localized guidelines. A panel of 30 experts from 17 provinces, municipalities, and autonomous regions in China collaboratively developed the Clinical Practice Guidelines for Tumor-related Lymphedema: Chinese Expert Consensus Based on the Delphi Method (2025 Version) by integrating the latest evidence-based medical findings and applying the Delphi method. This consensus addresses nine key dimensions: risk factors, monitoring and follow-up, patient education, diagnosis and evaluation, complex decongestive therapy, pharmacotherapy, surgical intervention, nutritional management, and multidisciplinary care. In total, 113 consensus recommendations were established, providing standardized guidance for the clinical management of tumor-related lymphedema.

     

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