《中国康复理论与实践》 ›› 2019, Vol. 25 ›› Issue (9): 1094-1097.doi: 10.3969/j.issn.1006-9771.2019.09.020

• 临床研究 • 上一篇    下一篇

低弹力绷带加压包扎对乳腺癌术后上肢纤维肿的疗效

谢娜1, 蒋柳雅2, 贾杰2,3   

  1. 1.北京大学国际医院康复医学科,北京市 102206
    2.上海市静安区中心医院康复医学科,上海市 200040
    3.复旦大学附属华山医院康复医学科,上海市 200040
  • 收稿日期:2019-04-10 修回日期:2019-06-10 出版日期:2019-09-25 发布日期:2019-09-25
  • 通讯作者: 贾杰,E-mail: shannonjj@126.com E-mail:shannonjj@126.com
  • 作者简介:谢娜(1989-),女,汉族,山西运城市人,硕士研究生,医师,主要研究方向:乳腺癌康复。
  • 基金资助:
    复旦大学-复星护理科研基金立项项目(No. FNF201736)

Effect of Compressive Low Elastic Bandage on Upper Limb Lymphedema after Breast Cancer Surgery

XIE Na1, JIANG Liu-ya2, JIA Jie2,3   

  1. 1.Department of Rehabilitation, Peking University International Hospital, Beijing 102206, China
    2.Department of Rehabilitation, Jing'an District Centre Hospital of Shanghai, Shanghai 200040, China
    3.Department of Rehabilitation, Huashan Hospital, Fudan University, Shanghai 200040, China
  • Received:2019-04-10 Revised:2019-06-10 Published:2019-09-25 Online:2019-09-25
  • Contact: JIA Jie, E-mail: shannonjj@126.com E-mail:shannonjj@126.com
  • Supported by:
    Supported by Fudan University-Fosun Nursing Research Foundation (No. FNF201736)

摘要: 目的 观察低弹力绷带加压包扎对乳腺癌术后上肢纤维肿的效果。 方法 2017年11月至2018年12月,乳腺癌术后上肢纤维肿患者64例随机分为对照组(n = 32)和观察组(n = 32)。两组均接受徒手淋巴引流和低弹力绷带包扎,观察组在发生纤维肿胀部位加海绵垫加压,共2周。于第1次治疗前(T1)、第2次治疗前(T2)、第3次治疗前(T3)、第6次治疗前(T4)、第10次治疗24 h后(T5),测量患者上肢生物电阻抗L-Dex值,在T1和T5时测量双侧定点臂围,计算健患侧臂围最大差值。 结果 T2后,两组L-Dex值均较T1时持续降低,观察组T4时略升高,且高于对照组(t = 2.13, P < 0.05),T5时低于对照组(t = -2.29, P < 0.05)。观察组臂围差值显著小于对照组(t = -3.78, P < 0.001)。 结论 低弹力绷带加压包扎较低弹力绷带包扎对纤维肿的治疗效果更佳。

关键词: 乳腺癌, 淋巴水肿, 纤维肿, 低弹力绷带, 加压包扎

Abstract: Objective To observe the effect of compressive low elastic bandage on upper limb lymphedema after breast cancer surgery. Methods From November, 2017 to December, 2018, 64 patients with upper limb lymphedema after breast cancer surgery were randomly divided into control group (n = 32) and observation group (n = 32). Both groups accepted manual lymphatic drainage and low elastic bandage, while the observation group increased the pressure with sponge pads on the fibrous swelling site as bandaging, five times a week for two weeks. They were measured L-Dex with bioelectrical spectroscopy before the first treatment (T1), before the second treatment (T2), before the third treatment (T3), before the sixth treatment (T4), and 24 hours after the tenth treatment (T5), respectively. The arm circumference of affected side and un-affected side was also measured at T1 and T5. Results L-Dex decreased since T2 in both groups, but increased at T4 in the observation group and more than that of the control group (t = 2.13, P < 0.05), and less than that of the control group at T5 (t = -2.29, P < 0.05). The difference of arm circumference between affected side and un-affected side was less in the observation group than in the control group (t = -3.78, P < 0.001)。 Conclusion Low elastic bandage combined with lymphatic drainage technique can alleviate the fibrous swelling. On the basis of low elastic bandage with local sponge pad compression is more effective than simple low elastic bandage on fibrous swelling after lymphedema of upper limbs after breast cancer surgery.

Key words: breast cancer, lymphedema, fibrous swelling, low elastic bandage, pressure bandage

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