应用手法淋巴引流综合消肿疗法治疗肢体淋巴水肿的效果观察

Effects of Complex Decongestive Therapy Combined with Manual Lymphatic Drainage in the Treatment of Lymphedema of Limbs

目的观察手法淋巴引流综合消肿疗法(Complex Decongestive Therapy,CDT)治疗各类肢体淋巴水肿的临床疗效。方法自2014年6月至2015年6月,对102例不同病因和部位的肢体淋巴水肿患者给予CDT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肿程度和人体BMI变化,卷尺测量患肢周径变化。治疗结束后嘱患者行自我CDT治疗。结果 102例患者经CDT治疗后患肢组织水肿程度、BMI指数和肢体周径均显著下降(P<0.001)。治疗前后水分、周径、BMI变化均具有明显相关性(r=0.445、0.567、0.572,P<0.001)。随访6个月,90%的患者坚持自我CDT治疗,无明显复发病例。结论 CDT治疗可显著减轻各类淋巴水肿患者的肢体水肿程度、降低BMI,后续坚持自我CDT治疗亦不可或缺。

Objective To observe the clinical efficacy of complex decongestive therapy(CDT)combined with manual lymphatic drainage in the treatment of lymphedema of limbs.Methods From June2014to June2015,102cases of limb lymphedema with different etiology and location were treated by CDT combined with manual lymphatic drainage for1course(4weeks).Multiple frequency bioelectrical body composition analyzer was used for monitoring the extent of tissue edema and human BMI changes,and the limb circumference changes were measured.Subsequent CDT self-treatment was ordered.Results The limb edema degree,BMI index and limb circumference were all significantly decreased after CDT treatment(P<0.001).The variation of water content,circumferential diameter and BMI before and after the treatment were all significantly correlated(r=0.445,0.567,0.572;P<0.001).All patients were followed up for6months,90%patients insisted on CDT self-treatment,and no obvious recurrence was observed.Conclusion CDT treatment can significantly eliminate the lymphedema of extremity edema and reduce BMI,and subsequent CDT self-treatment is also indispensable.