手法淋巴引流联合气压综合疗法对下肢淋巴水肿患者疗效研究
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摘要
目的研究手法淋巴引流联合气压综合疗法对下肢淋巴水肿患者的疗效。方法选取2017年5月至2018年5月在武汉协和医院康复科和血管外科就诊的50例下肢淋巴水肿患者,随机分为治疗组和对照组(各25例),治疗组接受手法淋巴引流综合疗法,对照组接受常规传统压力疗法。治疗一个疗程后检测组织水肿、疼痛视觉模拟评分量表评判治疗后疼痛情况并测量肢体周径大小来评估最终疗效。结果治疗前两组患者差异无统计学意义(P>0.05),1个疗程的治疗后,50例患者下肢情况均有所好转,对照组测量细胞外液含量、肢体周径差和VAS分别为(1.43±0.56)L、(3.82±0.67)cm和(3.42±0.57)分,而治疗组分别为(0.71±0.96)L、(2.65±1.65)cm和(1.58±0.29)分,患侧肢体均较治疗前组织水肿程度降低,疼痛减轻和患肢周径的显著缩小(P<0.05),而且治疗组较对照组效果更明显,差异性更大(P<0.05)。结论下肢淋巴水肿患者可以通过手法淋巴引流联合气压综合疗法有效地促进滞留组织淋巴水肿的回流,并显著地减轻肢体的肿胀和疼痛,是目前一种非常有效值得推广的治疗手段。
Objective A study on the efficacy of manipulative lymphatic drainage combined with pneumatic comprehensive therapy in patients with lower limb lymphedema. Methods 50 patients with lower limb lymphedema admitted to the rehabilitation department and vascular surgery department of wuhan union medical college hospital from May 2017 to May 2018 were selected. They were randomly divided into the treatment group and the control group(25 cases each). The treatment group received combined therapy of manipulative lymphatic drainage, while the control group received conventional pressure therapy. After one course of treatment, tissue edema, the visual analogue scale(VAS) and limb diameter were measured to evaluate the final effect. Results There was no statistically significant difference between the two groups before treatment(P >0.05). After one course of treatment, the lower limb condition of all the 50 patients improved. In the control group, extracellular fluid content, limb circumference difference and VAS were(1.43±0.56) L,(3.82±0.67) cm and(3.42±0.57) points, respectively. In the treatment group, the scores were(0.71±0.96) L,(2.65±1.65) cm and(1.58±0.29) respectively,The degree of tissue edema in the affected limb was lower than that before treatment, and the pain was reduced and the circumference of the affected limb was significantly reduced(P <0.05). In addition, the effect of the treatment group was more obvious than that of the control group, and the difference was larger(P <0.05). Conclusions Patients with lower limb lymphedema can effectively promote the reflux of retained tissue lymphedema by means of manipulative lymphatic drainage combined with pneumatic comprehensive therapy,and significantly reduced limb swelling and pain,It is a very effective treatment that deserves to be popularized at present.
Objective A study on the efficacy of manipulative lymphatic drainage combined with pneumatic comprehensive therapy in patients with lower limb lymphedema. Methods 50 patients with lower limb lymphedema admitted to the rehabilitation department and vascular surgery department of wuhan union medical college hospital from May 2017 to May 2018 were selected. They were randomly divided into the treatment group and the control group(25 cases each). The treatment group received combined therapy of manipulative lymphatic drainage, while the control group received conventional pressure therapy. After one course of treatment, tissue edema, the visual analogue scale(VAS) and limb diameter were measured to evaluate the final effect. Results There was no statistically significant difference between the two groups before treatment(P >0.05). After one course of treatment, the lower limb condition of all the 50 patients improved. In the control group, extracellular fluid content, limb circumference difference and VAS were(1.43±0.56) L,(3.82±0.67) cm and(3.42±0.57) points, respectively. In the treatment group, the scores were(0.71±0.96) L,(2.65±1.65) cm and(1.58±0.29) respectively,The degree of tissue edema in the affected limb was lower than that before treatment, and the pain was reduced and the circumference of the affected limb was significantly reduced(P <0.05). In addition, the effect of the treatment group was more obvious than that of the control group, and the difference was larger(P <0.05). Conclusions Patients with lower limb lymphedema can effectively promote the reflux of retained tissue lymphedema by means of manipulative lymphatic drainage combined with pneumatic comprehensive therapy,and significantly reduced limb swelling and pain,It is a very effective treatment that deserves to be popularized at present.
引文
[1]Fldi M,Fldi E.Fldi's Textbook of lymphology:for physicians and lymphedema therapists[M].Stuttgart:Urban&Fischer,2006.
[2]Ryan TJ.Lymphatics and adipose tissue[J].Clin Dermatol,1995,13(5):493-498.
[3]Lasinski BB.Complete decongestive therapy for treatment of lymphedema[J].Semin Oncol Nurs,2013,29(1):20-27.
[4]倪建芬,张永芳,李曼,等.乳腺癌患者上肢淋巴水肿疾病预防认知和行为现状分析[J].中华现代护理杂志,2016,22(27):3935-3937.
[5]Lu L,Zhu M,Luo X,et al.Using levator aponeurosis to create physiologically natural double eyelid:a new reconstruction technique based on three key factors in double eyelid formation[J].Ann Plast Surg,2017,78(5):487-491.
[6]Kakizaki H,Takahashi Y,Nakano T,et al.The causative factors or characteristics of the Asian double eyelid:an anatomic study[J].Ophthalmic Plast Reconstr Surg,2012,28(5):376-381.
[7]高万露,汪小海.视觉模拟疼痛评分研究的进展[J].医学研究杂志,2013,42(12):144-145.
[8]李树玲.乳腺肿瘤学[M].北京:科学技术文献出版社,2007:422-693.
[9]Hwang HS,Spiegel JH.The effect of"single"vs"double"eyelids on the perceived attractiveness of Chinese women[J].Aesthet Surg J,2014,34(3):374-382.
[10]Lee CK,Ahn ST,Kim N.Asian upper lid blepharoplasty surgery[J].Clin Plast Surg,2013,40(1):167-178.
[11]易成刚,郭树忠,张琳西,等.汉族人重睑发生率的荟萃分析[J].中华医学美学美容杂志,2004,10(6):370-372.
[12]窦祖林.作业治疗学[M].北京:人民卫生出版社,2008:208-213.
[13]刘飞,路潜,欧阳倩,等.乳腺癌患者术后淋巴水肿与其相关症状的关系研究[J].中华护理杂志,2016,51(5):518-522.
[14]Bakar Y,Coknaz H,Karl,et al.Effect of manual lymph drainage on removal of blood lactate after submaximal exercise[J].J Phys Ther Sci,2015,27(11):3387-3391.
[15]Gradalski T,Ochalek K,Kurpiewska J.Complex decongestive lymphatic therapy with or without vodder II manual lymph drainage in more severe chronic postmastectomy upper limb lymphedema:a randomized noninferiority prospective study[J].J Pain Symptom Manage,2015,50(6):750-757.
[16]Ezzo J,Manheimer E,McNeely ML,et al.Manual lymphatic drainage for lymphedema following breast cancer treatment[J].Cochrane Database Syst Rev,2015,5(5):CD003475.
[2]Ryan TJ.Lymphatics and adipose tissue[J].Clin Dermatol,1995,13(5):493-498.
[3]Lasinski BB.Complete decongestive therapy for treatment of lymphedema[J].Semin Oncol Nurs,2013,29(1):20-27.
[4]倪建芬,张永芳,李曼,等.乳腺癌患者上肢淋巴水肿疾病预防认知和行为现状分析[J].中华现代护理杂志,2016,22(27):3935-3937.
[5]Lu L,Zhu M,Luo X,et al.Using levator aponeurosis to create physiologically natural double eyelid:a new reconstruction technique based on three key factors in double eyelid formation[J].Ann Plast Surg,2017,78(5):487-491.
[6]Kakizaki H,Takahashi Y,Nakano T,et al.The causative factors or characteristics of the Asian double eyelid:an anatomic study[J].Ophthalmic Plast Reconstr Surg,2012,28(5):376-381.
[7]高万露,汪小海.视觉模拟疼痛评分研究的进展[J].医学研究杂志,2013,42(12):144-145.
[8]李树玲.乳腺肿瘤学[M].北京:科学技术文献出版社,2007:422-693.
[9]Hwang HS,Spiegel JH.The effect of"single"vs"double"eyelids on the perceived attractiveness of Chinese women[J].Aesthet Surg J,2014,34(3):374-382.
[10]Lee CK,Ahn ST,Kim N.Asian upper lid blepharoplasty surgery[J].Clin Plast Surg,2013,40(1):167-178.
[11]易成刚,郭树忠,张琳西,等.汉族人重睑发生率的荟萃分析[J].中华医学美学美容杂志,2004,10(6):370-372.
[12]窦祖林.作业治疗学[M].北京:人民卫生出版社,2008:208-213.
[13]刘飞,路潜,欧阳倩,等.乳腺癌患者术后淋巴水肿与其相关症状的关系研究[J].中华护理杂志,2016,51(5):518-522.
[14]Bakar Y,Coknaz H,Karl,et al.Effect of manual lymph drainage on removal of blood lactate after submaximal exercise[J].J Phys Ther Sci,2015,27(11):3387-3391.
[15]Gradalski T,Ochalek K,Kurpiewska J.Complex decongestive lymphatic therapy with or without vodder II manual lymph drainage in more severe chronic postmastectomy upper limb lymphedema:a randomized noninferiority prospective study[J].J Pain Symptom Manage,2015,50(6):750-757.
[16]Ezzo J,Manheimer E,McNeely ML,et al.Manual lymphatic drainage for lymphedema following breast cancer treatment[J].Cochrane Database Syst Rev,2015,5(5):CD003475.