6步综合消肿疗法在乳腺癌术后患者Ⅲ期上肢淋巴水肿中的应用

Application of 6-step comprehensive deswelling therapy in treatment of stageⅢupper limb lymphedema after mastectomy

目的探讨6步综合消肿疗法在乳腺癌术后Ⅲ期上肢淋巴水肿的应用效果。方法采用6步综合消肿疗法对2018年1月-2018年12月在本院淋巴水肿门诊的15例Ⅲ期上肢淋巴水肿患者进行干预,包括个性化皮肤护理、特殊技巧徒手淋巴引流、加泡沫块绷带空气波压力治疗、填充型弹性绷带加压包扎、患肢功能锻炼、体重管理等。干预时间56d,共40次,20次为1个疗程。比较干预前后两组患者的淋巴水肿程度(患臂周径变化、50Hz电阻和节段水分和细胞外水分)和生活质量。结果干预前后患者患臂周径变化情况比较,干预后均小于干预前,干预后患者患臂50Hz电阻抗高于干预前,患臂节段水分和细胞外水分低于干预前,生活质量各维度评分均高于干预前,两组比较,差异具有统计学意义(均P<0.001)。结论 6步综合消肿疗法能一定程度改善乳腺癌术后患者Ⅲ期淋巴水肿患肢淋巴水肿症状,从而提高患者的生活质量,值得临床推广应用。

Objective To explore the effect of 6-step comprehensive deswelling therapy on stageⅢupper limb lymphedema after mastectomy.Methods A total of 15 patients with stageⅢupper limb lymphedema after mastectomy admitted to the lymphedema clinic of our hospital from Jan.2018 to Dec.2018 were intervened with 6-step comprehensive deswelling therapy,including personalized skin care,specialized lymphatic drainage,air wave pressure treatment with foam block bandage,pressure bandage dressing,functional exercise of affected limb,and weight management.The intervention lasted for 56 days in 40 times,with 20 times as a treatment course.The lymphedema degrees including the circumference of the affected arm,50 Hz resistance and segmental and extracellular water,together with quality of life,were compared between pre-and post-intervention.Results After two courses of treatment,the circumferences were significantly decreased(P<0.001);The 50Hz resistance value of the affected side were significantly higher than before intervention(P<0.001);and the segmental water and extracellular water were significantly reduced as well(P<0.001).After treatment,the quality of life was significantly improved as compared to pre-intervention(P<0.001).Conclusion The 6-step comprehensive deswelling therapy can improve the symptoms of lymphedema in the patients'affected limbs so that it can improve their quality of life.Therefore,it is worthy of clinically spreading.