组织工程与重建外科杂志2025，Vol.21Issue(1)：10-13,4.DOI:10.3969/j.issn.1673-0364.2025.01.002
颈部Ⅱ/Ⅲ区淋巴管/结-静脉分流术治疗阿尔茨海默病的初步临床疗效观察
Preliminary clinical efficacy observation of lymphatic/lymph node-venous shunt surgery in cervical region Ⅱ/Ⅲ for the treatment of Alzheimer's disease
摘要
Abstract
Objective To propose a lymphatic/lymph node-venous shunt in the cervical Ⅱ/Ⅲ region,and to explore the therapeutic principles and efficacy of this method in treating Alzheimer's disease(AD).Methods Patients underwent the lymphatic/lymph node-venous shunt surgery in the cervical Ⅱ/Ⅲ region.Cognitive assessments,including the MMSE,MoCA,and NPI,were conducted before and one month after surgery to evaluate symptom improvement.PET-CT was used to quantitatively analyze changes in intracranial Aβ protein levels.Color Doppler ultrasound was employed to measure the patency of the internal jugular vein and detect wall-adherent thrombus formation.Postoperative follow-up within one month included monitoring wound healing,hematoma or fluid accumulation,lymphatic leakage,postoperative delirium,headaches,and other discomforts.Results This study included 7 AD patients(3 males and 4 females)with an average age of 65(57-71)years.All patients had AD with dementia.Compared to preoperative scores,one month postoperatively,MMSE improved by 0(-2,1)points(P=0.581),MoCA improved by 0(-1,1)points(P=1.000),NPI(frequency×severity)improved by 9(9,20)points(P=0.043),and NPI caregiver distress improved by 2(2,6)points(P=0.026).Color Doppler ultrasound indicated patent internal jugular venous flow without wall-adherent thrombus.No adverse reactions were observed.Three patients underwent PET-CT one month postoperatively,showing an average reduction of 12.3% in whole-brain Aβ protein levels.Conclusion The proposed lymphatic/lymph node-venous shunt surgery in the cervical Ⅱ/Ⅲ region can divert the extracranial segment of intracranial lymphatic drainage,promote the clearance of pathological proteins,reduce intracranial Aβ protein levels,and improve clinical symptoms.This procedure may become a viable treatment option for AD,advancing the development of surgical interventions for AD.关键词
阿尔兹海默病/淋巴管/淋巴结/静脉分流术Key words
Alzheimer's disease/Lymphatic vessels/Lymph nodes/Venous shunt分类
临床医学引用本文复制引用
李科,王雪茜,韩承尧,孙宇昊,刘珈杞,吴京殊,魏艳雪,宋幸奇,章一新,文科,艾松涛,严佳,汪海娅,李赞,李彬,闵沛如,孟心娴..颈部Ⅱ/Ⅲ区淋巴管/结-静脉分流术治疗阿尔茨海默病的初步临床疗效观察[J].组织工程与重建外科杂志,2025,21(1):10-13,4.基金项目
国家自然科学基金项目(82000456). （82000456）
