肢体淋巴水肿CDT疗法治疗周期的初步探讨  

Preliminary study on the period of CDT therapy for limb lymphedema

作　　者：陈佳佳[1] 汪立[1] 于子优 韩凌华 刘宁飞[1] Chen Jiajia;Wang Li;Yu Ziyou;Han Linghua;Liu Ningfei(Department of plastic surgery,Ninth People＇s Hospital Affiliated to Shanghai Jiaotong University School of Medicine,Shanghai 200011,China)

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淋巴中心,200011

出　　处：《中华整形外科杂志》2018年第10期844-847,共4页Chinese Journal of Plastic Surgery

摘　　要：目的探讨手法淋巴引流综合消肿治疗（CDT）对肢体淋巴水肿的适宜治疗周期，即治疗时间与疗效的关系。方法2015年1月至12月，203例确诊为肢体淋巴水肿的患者按水肿程度和纤维化程度分4期，即4组，均给予CDT疗法治疗1个疗程（4周）。治疗期间采用多频生物电阻人体成分分析仪监测组织水分变化，卷尺测量患肢周径变化。用SPSS 19.0软件分析所得数据。结果203例患者经CDT治疗后患侧肢体组织水分和肢体周径均显著下降（P〈0.01）。组织水分动态变化中，1期患者组织水分的变化第1周与第2周比较差异有统计学意义（P〈0.01），第2、3、4周之间无显著差异；2～4期患者第1周与第2周、第2周与第3周比较差异均有统计学意义（P〈0.05），第3周与第4周比较差异无统计学意义。周径动态变化中，1期和2期患者周径每周的变化无显著差异；3期患者第1周与第2周、第2周与第3周比较差异均有统计学意义（P〈0.05），最后2周无显著差异；4期患者第1周与第2周、第3周与第4周比较差异有统计学意义（P〈0.01），第2周与第3周差异无统计学意义。组织水分与周径具有相关性（r＝0.643）。患者主观感觉好。结论CDT疗法治疗淋巴水肿疗效显著。1期水肿至少治疗2周为宜；2期、3期水肿至少治疗3周为宜；4期水肿至少治疗4周为宜。建议CDT疗法治疗至少维持半年左右。Objective To explore the appropriate treatment cycle of complex decongestive Therapy （CDT） for extremity lymphedema, which is the summary of the relationship between treatment time and curative effect.Methods From January to December 2015, 203 patients with limb lymphedema were divided into four stages according to the degree of edema and the degree of fibrosis, that is, four groups. All patients were given CDT treatment for a course of treatment （4 weeks）. During the treatment period, the multi frequency bioelectrical resistance body composition analyzer was used to monitor the change of tissue moisture and the tape diameter was used to measure the circumference of the affected limb. SPSS software is used to analyze the data.Results 203 cases were treated with CDT therapy. Water in limb tissue and limb circumference of affected side was decreased significantly （P〈0.01）. To the tissues water dynamic changes, in the first group there was a significant difference （P〈0.01） in the first week and second week. There was no obvious difference in 2-4 weeks; In the 2, 3 and 4 groups, there was significant difference in the first week and the second week, as well as the second week and the third week （P〈0.05）. And there was no difference in the third and fourth week. To the circumference dynamic change, in the first group there was no significant difference in patients in the first and the second week; In the third group, there was significant difference in the first week and the second week, as well as the second week and the third week （P〈0.05）. There was no significant difference in the last two weeks; In the fourth group, there was significant difference in the first week and the second week, as well as the third week and the fourth week（P〈0.01）. There was no difference in the second week and the third week. There is a correlation between the tissue water and the circumferential diameter （r=0.643）. The patient has a good subjective feeling.Conclusions CDT therapy is effective i

关 键 词：淋巴水肿 手法淋巴引流综合消肿治疗 治疗周期 

分 类 号：R622[医药卫生—整形外科]