压力袖套辅助淋巴引流对乳腺癌术后患者上肢淋巴水肿的影响

Effects of pressure cuff assisted lymphatic drainage on upper limb lymphedema in patients after breast cancer surgery

目的:探讨压力袖套辅助淋巴引流对乳腺癌术后患者上肢淋巴水肿的影响。方法:选取68例乳腺癌根治术后上肢淋巴水肿的患者,随机分为压力衣辅助佩戴组(A组)和单纯淋巴引流组(B组)。B组接受为期11天,每天45min的淋巴引流手法治疗。A组在每天45min淋巴引流手法后予以患肢压力袖套佩戴。两组患者分别于第1次淋巴引流前(T0)、第1次淋巴引流后(T1)、第2次引流前(T2)、第3次引流前(T3)、第6次引流前(T4)、第11次引流前(T5),第11次引流24h后(T6),测量患者上肢的生物电阻抗(BIS),输出L-Dex比值。并在T1、T6时间测量两组患者的健患侧定点臂围,对采集到的数据进行组间及组内比较。结果:(1)L-Dex值:第1次治疗后,A、B两组均明显降低(P<0.05);第2次治疗前均开始上升,A组上升幅度明显低于B组;A组持续降低(P<0.05),B组出现波动;经过11天的治疗后,两组均有下降,但A组明显低于B组(P<0.05)。(2)臂围:11次治疗后健患侧臂围差变化A组明显大于B组(P<0.05)。结论:单纯淋巴引流手法及淋巴引流手法结合压力袖套治疗均能在一定程度上缓解乳腺癌术后患侧上肢淋巴水肿,而予淋巴引流手法治疗后联合压力袖套治疗,较单纯淋巴引流手法对淋巴水肿的治疗效果更明显。

Objective： To investigate the effect of pressure cuff assisted lymphatic drainage on upper limb lymphedema after breast cancer surgery. Method： Totally 68 patients with upper limb lymphedema after radical mastectomy were randomly divided into two groups： pressure clothing auxiliary wearing group （group A） and simple lymphatic drainage group （group B）. Group B received 11 days of 45min lymphatic drainage every day. In group A, limb pressure cuff was worn after 45min lymphatic drainage every day. The bioelectrical impedance（BIS） of upper limb and output ratio of L-Dex were detected at different time point： before the first lymphatic drainage （T0）,after the first lymphatic drainage（T1）, before the second lymphatic drainage（T2）, before the third drainage （T3）, before the sixth drainage （T4）, before the eleventh drainage （T5） and 24h after the eleventh drainage（T6）. At the T1 and T6 time point, the fixed arm circumference of affected side was measured, and the data collected was compared between two groups. Result： L-Dex value：for both groups, L-Dex value significantly decreased after the first treatment, and began to rise before the second treatment（P〈0.05）. Additionally, the A group was significantly lower than the B group and showed the continuous decrease （P〈0.05）, while the B group fluctuated. After 11 days of treatment, the two groups were decreased. However, the A group was significantly lower than that of the B group （P〈0.05）. Arm circumference： after 11 times of treatment, the change of A group was significantly greater than that of B group （P〈0.05）. Conclusion： Lymphatic drainage technique or lymphatic drainage technique combined with pressure cuff treatment can alleviate the lymphedema of affected upper limb for patients with breast cancer. Moreover, lymphatic drainage combined with pressure cuff had more obvious therapy effect when compared with lymphatic drainage treatment.