头颈部淋巴外科治疗阿尔茨海默病的随机对照临床试验

doi:10.19438/j.cjoms.2026.05.005

中国口腔颌面外科杂志 ›› 2026, Vol. 24 ›› Issue (5): 470-476.doi: 10.19438/j.cjoms.2026.05.005

头颈部淋巴外科治疗阿尔茨海默病的随机对照临床试验

任振虎^1,2,*,#, 王世宇^1,*, 李柯燕³, 张晓晨¹, 张志愿¹, 何悦¹, 李霞^4#

1.上海交通大学医学院附属第九人民医院口腔颌面-头颈肿瘤科,上海交通大学口腔医学院,国家口腔医学中心,口腔疾病国家临床医学研究中心,上海市口腔医学重点实验室,上海市口腔医学研究所,上海 200011;
2.河南大学淮河医院,河南开封 475000;
3.上海交通大学口腔医学院,上海 200125;
4.上海交通大学医学院附属精神卫生中心,国家精神疾病医学中心,上海 200030

收稿日期:2026-03-18 修回日期:2026-05-15 出版日期:2026-09-20 发布日期:2026-10-10
通讯作者: 任振虎,E-mail: zhenhuren@126.com;李霞,E-mail: a_1023@aliyun.com。^#共同通信作者
作者简介:任振虎（1986—）,男,博士,主任医师;王世宇（2001—）,男,在读硕士研究生,E-mail: 19821813502@163.com。^*并列第一作者

Randomized controlled trial of head and neck lymphatic surgery for Alzheimer's disease

Ren Zhenhu^1,2, Wang Shiyu¹, Li Keyan³, Zhang Xiaochen¹, Zhang Zhiyuan¹, He Yue¹, Li Xia⁴

1. Department of Oromaxillofacial Head and Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology; Shanghai Research Institute of Stomatology. Shanghai 200011;
2. Huaihe Hospital of Henan University. Kaifeng 475000, Henan Province;
3. College of Stomatology, Shanghai Jiao Tong University. Shanghai 200125;
4. Shanghai Jiao Tong University Mental Health Center, National Center for Mental Disorder. Shanghai 200030, China

Received:2026-03-18 Revised:2026-05-15 Online:2026-09-20 Published:2026-10-10

摘要/Abstract

摘要： 目的：探讨颈颅类淋巴分流疏通术这一头颈部淋巴外科术式治疗阿尔茨海默病（Alzheimer's disease,AD）的安全性及有效性,为AD的临床干预提供新的参考和选择。方法：选择2024年1月—6月上海交通大学医学院附属第九人民医院、上海市精神卫生中心收治的10例AD患者作为研究对象,采用随机数字表法分为试验组和对照组,每组各5例。试验组在服用AD相关药物的同时进行颈颅类淋巴分流疏通术治疗,对照组继续服用AD相关药物及相关非手术治疗。分别采集两组术前（入组基线）,术后（入组后）3、6、12、18 个月多维度神经心理量表数据,组内纵向对比、组间横向对比量表评分变化,综合评估手术安全性与有效性。结果：量表数据分析显示,试验组3例痴呆进展得到遏制,病情较术前无进行性加重,其余2例认知损害仍呈进展趋势;对照组仅1例病情维持基线水平,其余4例痴呆程度持续进展。试验组所有患者围术期及术后定期随访中均未出现术区出血、感染等不良反应。结论：相较于单纯常规药物保守方案,颈颅类淋巴分流疏通术治疗AD可获得较好的安全性及暂缓疾病进展的初步有效性,有望成为AD外科干预的全新突破口。本研究样本量较小,后续需继续扩大样本量,进一步验证该术式的疗效。

关键词: 头颈部淋巴外科, 颈颅类淋巴分流疏通术, 阿尔茨海默病

Abstract: PURPOSE: To investigate the safety and efficacy of cervical shunting to unclog cerebral lymphatic systems surgery (CSULs) in patients with Alzheimer's disease (AD), so as to provide a new reference and alternative for clinical intervention of AD. METHODS: A total of 10 patients diagnosed with AD hospitalized from January to June 2024 at Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine and Shanghai Mental Health Center were enrolled as research subjects. The patients were divided into an experimental group and a control group via the random number table method, with 5 cases in each group. Patients in the experimental group received CSULs combined with routine anti-AD medications, whereas those in the control group continued conventional anti-AD pharmacotherapy and non-surgical conservative management only. Preliminary safety/efficacy were evaluated by comparing intra- and inter-group changes in neuropsychological scale scores from baseline to 3, 6, 12 and 18 months. RESULTS: Statistical analysis of scale scores demonstrated that disease progression was arrested in 3 patients of the experimental group without progressive deterioration relative to baseline, while cognitive impairment continued to deteriorate in the remaining 2 cases. In the control group, only 1 patient maintained stable baseline status, and progressive dementia was observed in the other 4 patients. No perioperative or long-term postoperative adverse events such as surgical site hemorrhage or surgical infection were recorded among all patients in the experimental group during regular follow-up. CONCLUSIONS: Compared with conventional medication-only conservative therapy, CSULs present favorable safety and preliminary efficacy in slowing AD progression, indicating promising potential as an innovative breakthrough for surgical intervention of AD. Given the limited sample size of the present trial, further large-sample clinical investigations are required to verify the therapeutic effect of this surgical technique.

Key words: Head and neck lymphatic surgery, Cervical shunting to unclog cerebral lymphatic systems surgery, Alzheimer's disease

中图分类号:

R749.1
R782

任振虎, 王世宇, 李柯燕, 张晓晨, 张志愿, 何悦, 李霞. 头颈部淋巴外科治疗阿尔茨海默病的随机对照临床试验[J]. 中国口腔颌面外科杂志, 2026, 24(5): 470-476.

Ren Zhenhu, Wang Shiyu, Li Keyan, Zhang Xiaochen, Zhang Zhiyuan, He Yue, Li Xia. Randomized controlled trial of head and neck lymphatic surgery for Alzheimer's disease[J]. China J Oral Maxillofac Surg, 2026, 24(5): 470-476.

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头颈部淋巴外科治疗阿尔茨海默病的随机对照临床试验

Randomized controlled trial of head and neck lymphatic surgery for Alzheimer's disease

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