慢性丝虫病淋巴水肿患者关怀照料效果

Effect of comprehensive care for chronic filariasis patients with lymphedema

目的观察慢性丝虫病淋巴水肿患者关怀照料前后病情变化及效果。方法采用中药泡脚、单味中药洗脚、清水清洗、消除侵入性伤口、锻炼、抬高患肢和穿鞋等综合照料方法,对慢性丝虫病淋巴水肿患者进行关怀照料。观察照料前、后淋巴管/结炎发作的频次、淋巴水肿病情分期和腿围等变化。结果完成观察照料共386例,淋巴管结炎发作率照料前为9.65%,照料后为4.67%,差异有统计学意义(χ2=7.34,P=0.006 7)。左、右侧患肢淋巴水肿分期高的患者照料后比例明显降低,较照料前差异均有统计学意义(Z=-1.99、-2.14,P=0.048 2、0.033 3),两侧患肢的Ⅱ线和Ⅲ线腿围照料后差异均有统计学意义(P均<0.01),腿围平均减少1.06 cm,皮肤外观也有明显改善,凹陷性水肿、溃疡、皮肤表层、皮肤皱褶等照料前、后差异均有统计学意义(P均<0.01)。结论慢性丝虫病淋巴水肿综合照料方法效果明显,值得进一步推广应用。

Objective To evaluate the effect of chronic filariasis patients with lymphedema after comprehensive cared. Meth- ods A total of 386 chronic filariasis patients with lymphedema received the comprehensive care including soaking feet by TCM, washing feet by single Chinese medicine or clear water, preventing and eliminating invasive wound, physical training, raising the limb, and wearing suitable shoes. The attack frequency of inflammation of lymphatic vessels, the stage of lymphedema dis- ease, and leg circumference were observed before and after the care. Results After the comprehensive care, the attack rates of inflammation of lymphatic vessels decreased from 9.65% to 4.67%, and there was a significant difference （ X 2=7.34, P=O.O06 7）. The proportion of the patients with high stage of lymphedema disease decreased significantly （all P 〈 0.01）, and the average leg circumference decreased of 1.06 cm. The skin appearance improved significantly. Other signs, such as pitting edema, ulcer, and skin folds also improved significantly （all P 〈 0.01）. Conclusion The comprehensive care for chronic filariasis patients with lymphedema has a remarkable effect and is worthy of further application.