综合消肿疗法治疗恶性肿瘤术后下肢淋巴水肿临床研究

Complex decongestion therapy of malignant tumor postoperative lower limb lymphedema

目的探讨综合消肿疗法(CDT)治疗恶性肿瘤术后单侧下肢淋巴水肿的疗效。方法回顾性分析沈阳军区总医院肿瘤科2016年1月至2017年2月收治的42例恶性肿瘤根治术后引起单侧下肢淋巴水肿患者的临床资料。根据患侧下肢周径将患者分为3组:轻度组18例,中度组14例,重度组10例。所有患者均给予CDT治疗,测量CDT治疗前后患肢周径。结果 CDT治疗2个疗程,本组42例患者下肢水肿的周径值均低于治疗前,差异有统计学意义(P<0.05);治疗后疼痛程度均较治疗前明显减轻,差异有统计学意义(P<0.05)。所有患者均获得1年的随访,未见明显复发及加重。结论 CDT是治疗恶性肿瘤术后下肢淋巴水肿安全、有效的方法,且能长期治疗,适用于各期手术后发生的下肢继发性淋巴水肿,包括重度淋巴水肿。

Objective To investigate the curative effect of complex decongestion therapy（CDT） treating unilateral lower limb lymphedema after radical resection. Methods A retrospective study was performed on 42 patients with unilateral lower extremity lymph edema induced by malignant tumor who were treated after radical resection from January 2016 to February2017. The patients were divided into 3 groups according to the difference of the circumference of the lower limb of the affected side： mild group（n = 18）,moderate group（n = 14） and severe group（n = 10）. All patients were treated with CDT,and the limb circumference before and after treatment were measured. Results After 2 cycles of CDT treatment,the limb circumferences of all patients with lower extremity edema were significantly less than those before treatment（P〈0. 05）; the degree of pain in all patients after treatment was significantly lower than that before treatment（P〈0. 05）. Observation on the treatment of patients were followed up for 1 year without recurrence. Conclusion CDT is a safe and effective treatment of postoperative lower limb lymphedema in malignant tumor,which can maintain long-term therapeutic effect. CDT is suitable for all patients with secondary lymphedema after surgery,including severe lymphedema.