烘绑疗法控制肢体慢性淋巴水肿伴发丹毒80例疗效分析  

Therapeutic effect of heating and bandage treatment for chronic lymphedema of extremities accompanied with erysipelas： a report of 80 cases

作　　者：李科[1] 刘宁飞[1] 付兰芬 汪立[1] 陈佳佳[1] 梁辰[2] 章一新[1] 

机构地区：[1]上海交通大学医学院附属第九人民医院整形外科,200011 [2]上海交通大学公共卫生学院

出　　处：《中华整形外科杂志》2015年第1期39-42,共4页Chinese Journal of Plastic Surgery

基　　金：国家自然科学基金（81272146）;上海市科委科技攻关计划（12401900504）

摘　　要：目的 探讨烘绑疗法治疗肢体慢性淋巴水肿伴发丹毒的效果.方法 回顾性分析2004年3月至2013年3月收治的80例肢体慢性淋巴水肿伴发丹毒患者行烘绑疗法的临床资料.采用上海市第九人民医院自制远红外烘疗机,温度一般为42℃左右,每天烘疗2h,20 h为1个疗程.每天治疗结束后患者用弹力绑带包扎.平均每年定期进行1～2个疗程.对丹毒发作频率、患者主观感觉、治疗总疗程、弹性材料使用情况进行随访观察.用秩和检验的方法比较发作频率的变化,使用SPSS 17.0统计软件分析数据.结果 烘绑治疗后,患者丹毒发作频率得到了明显的控制（Z =7.598,P=0.000）,其中60例（75％）患者不再伴发丹毒;对于不同发病原因导致的淋巴水肿伴发丹毒都有明显疗效,原发性和继发性分别与治疗前比较,差异均有统计学意义,P值分别为0.001和0.000,Z值分别为3.417和5.009,主观感觉明显改善,后续弹性材料加压治疗减少了丹毒复发.结论 烘绑疗法可以有效控制肢体慢性淋巴水肿患者的丹毒发作,提高生活质量,后续弹性材料加压治疗是必要的.Objective To investigate the therapeutic effect of heating and bandage treatment for chronic lymphedema of extremities accompanied with erysipelas.Methods From March 2004 to March 2013,80 patients with chronic lymphedema of extremities accompanied with erysipelas were analyzed retrospectively.The patients underwent heating treatment （42 degree centigrade） with infrared light machine made by Shanghai Ninth People＆#39; s Hospital,2 hours a day,20 hours for a session.Bandage treatment was adopted after heating treatment.1 or 2 sessions were performed for each patient every year.The erysipelas occurring frequency,patients subjective feeling,treatment sessions and elastic material usage was recorded during the follow-up period.The erysipelas occurring frequency was tested by the method of rank and inspection.SPSS 17.0 was used for statistical analysis.Results After heating and bandage treatment,the occurrence frequency of erysipelas was obviously controlled （Z =7.598,P =0.000）.Erysipelas was not occurred any more in 60（75%）patients.Remarkable reduction of occurrence frequency of erysipelas caused by various reasons was showed after treatment.Primary and secondary lymphedema after treatment were compared with those before treatment respectively,showing statistical difference（Z =3.417 and 5.009,P =0.001 and 0.000）.Most of patients felt better subjectively.The relapse rate of erysipelas and lymphedema was lower if keeping using elastic material to give more pressure on extremities after therapy.Conlusions Heating and bandage treatment can obviously reduce the occurrence frequency of erysipelas.It can improve the quality of patients＆#39; lives.Simultaneously,the subsequent elastic material pressure therapy is essential.

关 键 词：淋巴水肿 丹毒 烘绑疗法 

分 类 号：R551.2[医药卫生—血液循环系统疾病]