Liao Su Fen, Huang Mu Shen, Chou Ya Hui, Wei Ta Sen
Department of Physical Medicine and Rehabilitation, Changhua Christian Hospital, Changhua, Taiwan.
J Formos Med Assoc. 2003 Jun;102(6):404-6.
Development of secondary lower extremity lymphedema after cervical cancer is common. However, severe lymphedema of the female genitalia and vesicular cutaneous lymphatic reflux without lower limb lymphedema after treatment of cervical cancer is rare. We report successful complex decongestive physiotherapy (CDP) in a 53-year-old female who developed recurrent folliculitis, lymphocutaneous reflux, warty change of the right labium majora, and lymphedema involving the external genitalia after receiving hysterectomy, pelvic lymph node dissection, and radiation. CDP included skin care, manual lymphatic drainage, exercise, and use of a hip spica bandage and panty girdle garment. Oral antibiotics were prescribed to control the skin infection. Lymphatic discharge and folliculitis were markedly improved after a 3-week course of treatment. Traditional conservative treatment with pneumatic compression and massage is ineffective and not suitable in controlling lymphedema of the external genitalia. Use of CDP may help to relieve the symptoms and recurrent infection in patients with this condition.
宫颈癌后继发性下肢淋巴水肿很常见。然而,宫颈癌治疗后女性生殖器严重淋巴水肿且无下肢淋巴水肿的水疱性皮肤淋巴反流很少见。我们报告了一例53岁女性成功接受综合消肿物理治疗(CDP)的病例,该患者在接受子宫切除、盆腔淋巴结清扫和放疗后出现复发性毛囊炎、淋巴皮肤反流、右侧大阴唇疣状改变以及涉及外生殖器的淋巴水肿。CDP包括皮肤护理、手动淋巴引流、运动以及使用髋人字绷带和束腹带。开具口服抗生素以控制皮肤感染。经过3周的治疗疗程,淋巴引流和毛囊炎明显改善。传统的气动压迫和按摩保守治疗在控制外生殖器淋巴水肿方面无效且不适用。使用CDP可能有助于缓解这种情况下患者的症状和反复感染。