肢体淋巴水肿微波烘疗对淋巴回流的影响

Effects of Microwave Heating on Lymph Flow in the Lymphedema of Extremities

目的探讨烘疗对肢体淋巴回流的影响。 方法采用99mTc-Dextran和SPECT对 2 6例肢体淋巴水肿患者进行治疗前后淋巴显像的研究 ,测量比较淋巴回流速度 (LFS)、注射部位的半排时间 (T1/ 2 )及淋巴管图像的变化。 结果微波烘疗前 ,患肢的平均LFS明显低于对侧健肢 ,分别为 7.82cm/min和 10 .41cm/min ;2个疗程治疗后 ,患肢平均LFS增加到 9.36cm/min。而T1/ 2 烘疗前淋巴水肿肢体为 15 4.2 1min ,高于健肢的 91.5 5min ,烘疗后显著下降为 115 .38min。淋巴淤滞图像 2 6例中 2 2例治疗后得到改善 ,尤以感染性肢体淋巴水肿显著。 结论肢体淋巴水肿存在明显的淋巴回流淤滞 ,微波烘疗能促进淋巴水肿肢体的淋巴回流。

Objective To investigate the changes of lymph flow by microwave heating which had achieved an excellent result in the management of lymphedema of extremities. Methods 26 cases with lymphedema of the extremities had been evaluated by means of lymphoscintigraphy using 99m T c-Dextran and SPECT to examine the lymph flow speed and half-time(T 1/2 )clearance of the injection site as well as lymphatic images of the affected limbs before and after treatment. Results The average lymph flow speed in the affected limbs was significantly lower than that of the contralateral normal limbs with 7.82cm/min and 10.41cm/min respectively before treatment, and they increased significantly from 7.82 to 9.36cm/min after two courses of treatment; in contrary, T 1/2 was higher in the lymphedematous limbs with an average value of 154.21 min in comparison with 91.55 min contralaterally, and decreased significantly to 115.38 min after treatment. In addition, lymphatic image disturbances improved markedly in 22/26 cases(84.6%) after treatment, especially in the patients with infectious lymphedema, and showed no changes in two cases. Conclusion The results demonstrated that there was evident lymph flow stasis in lymphedematous limbs, based on the preliminary calculation of lymph flow indexes; microwave heating could promote the lymph flow in lymphedema of extremities.