目的探讨七步综合消肿疗法(CDT)治疗乳腺癌术后上肢淋巴水肿的效果。方法2015年8月至2016年9月,乳腺癌术后上肢淋巴水肿患者71例,采用七步CDT对患者进行干预,包括皮肤护理、开通淋巴通路、舒缓瘢痕组织、徒手淋巴引流、绷带加压包扎、压力波治疗、功能锻炼,共20 d。治疗前及治疗1 d、5 d、10 d、15 d、20 d分别测量上肢8个部位的周径,计算双侧周径差。结果治疗1~15 d,周径差较治疗前增加(Z>2.03, P<0.05),治疗20 d周径差明显缩小(Z=3.01, P<0.01)。结论七步CDT治疗淋巴水肿有效,但初期会出现水肿加重、反复波动,至20 d水肿程度明显减轻。这可能与急性应激反应或淋巴液重新分布有关。
ObjectiveTo explore the effects of seven-step complex decongestion therapy (CDT) on post-operative upper limb lymphedema of breast cancer. MethodsFrom August, 2015 to September, 2016, 71 patients with upper limb lymphedema after breast cancer surgery accepted CDT for 20 days, including skin care, opening of lymphatic pathway, relief of scar tissue, manual lymphatic drainage, bandage compression, air pressure wave therapy and functional exercise. The circumference of eight sites of both limbs was measured and the differences were calculated before treatment, and one, five, ten, fifteen and twenty days of the treatment. ResultsThe differences of circumference increased one to 15 days of the treatment (Z>2.03, P<0.05), and decreased 20 days of the treatment (Z=3.01, P<0.01). ConclusionCDT is effective on lymphedema after breast cancer surgery for 20 days of a course, but may worsen in the first 15 days, which may be related to acute stress response or redistribution of lymph.
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