手法淋巴引流综合消肿疗法治疗盆腔恶性肿瘤根治术后下肢淋巴水肿  

Complex Decongestion Therapy in Treating Lower Limb Lymphedema after Radical Operation of Pelvic Malignant Tumor

作　　者：汪立[1] 陈佳佳[1] 于子优 韩凌华 孙笛[1] 罗毅[1] 刘宁飞[1] 

机构地区：[1]上海交通大学医学院附属第九人民医院整复外科,上海市200011

出　　处：《组织工程与重建外科杂志》2016年第3期186-188,共3页Journal of Tissue Engineering and Reconstructive Surgery

摘　　要：目的探讨手法淋巴引流综合消肿疗法(Complex Decongestion Therapy,CDT)治疗盆腔肿瘤根治术后下肢淋巴水肿的疗效。方法自2011年起,收治76例盆腔肿瘤根治术后的单侧下肢淋巴水肿患者,其中子宫颈癌、子宫内膜癌和卵巢癌根治术后的女性患者70例,直肠、前列腺癌手术后的男性6例。按照健患侧下肢周径的差异,将患者分为3组:轻度组30例,中度组24例,重度组22例。患者均进行1个疗程(20天d)的CDT治疗,采用多频生物电阻人体成分分析仪和肢体周径测量观察治疗效果。结果治疗后所有患肢的水肿明显减轻,组织内水分比率显著减少(P<0.01),周径比率显著缩小(P<0.01)。3组中,中度组和重度组的水分下降更为显著,重度组的周径缩小最为显著。结论手法淋巴引流综合消肿治疗是治疗盆腔肿瘤根治手术后下肢淋巴水肿有效、安全的治疗手段。手法淋巴引流综合治疗适用于各期手术后下肢继发性淋巴水肿,包括重度淋巴水肿。Objective To explore the effectiveness of Complex Decongestion Therapy（CDT） in the treatment of lower limb lymphedema related to pelvic malignant tumor. Methods Since 2011, 76 patients with unilateral lower limb lymphedema after radical operation of pelvic tumors were treated, composed of 70 women after the operation of cervical cancer, endometrial cancer, ovarian cancer and 6 men after the operation of rectal cancer and prostate cancer. According to the circumference of edema, patients were divided into three groups： mild in 30 cases, moderate in 24 cases, severe in 22 cases. Each group accepted 1 treatment course（20 days）. The result of CDT treatment was evaluated with measurement of circumference of extremities and Multiple-frequency bioelectrical impedance analysis. Results After 1 treatment course, all patients showed significant reduction in circumference of the edematous limbs（ P0.01） and edema fluid in tissue（P0.01）.The patients in severe group and moderate group showed more efficacy in water reduce. The patients in severe group showed more efficacy in circumference reduce. Conclusion Complex decongestive therapy is effective and safe to treat lower limb lymphedema after radical operation of pelvic tumor. It is also applied to each period of secondary lymphedema of lower limb after operation, including severe lymphedema.

关 键 词：淋巴水肿 手法淋巴引流 盆腔肿瘤根治手术 下肢水肿 

分 类 号：R551.2[医药卫生—血液循环系统疾病]