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[乳腺癌治疗后上肢淋巴水肿的管理]

[Management of lymphedema of the upper extremity after treatment of breast cancer].

作者信息

Arrault Maria, Vignes Stéphane

机构信息

Unité de lymphologie, hôpital Cognacq-Jay, 15, rue Eugène Millon, 75015 Paris.

出版信息

Bull Cancer. 2007 Jul;94(7):669-74.

Abstract

Management of breast cancer-related lymphedema is based on complex decongestive physiotherapy including two phases. The first intensive phase reduces lymphedema volume with daily low stretch bandages associated with manual lymph drainage. Treatment includes exercises and skin care. The second phase of treatment consists of stabilization of lymphedema volume with regular overnight self-bandaging, daily elastic compression garment and manual lymph drainage if needed. Lymphedema volume may be stabilized after the intensive phase if the patient is compliant to long term treatment. Practical advices such as weight control and skin care to avoid cellulitis should be given. Regular and prolonged medical follow-up is required for this chronic disease to maintain motivation of the patient.

摘要

乳腺癌相关淋巴水肿的管理基于复杂的消肿物理治疗,包括两个阶段。第一阶段为强化阶段,通过每日使用低张力绷带结合手法淋巴引流来减少淋巴水肿的体积。治疗包括锻炼和皮肤护理。治疗的第二阶段包括通过定期夜间自我绷带包扎、每日穿戴弹力加压服装以及必要时进行手法淋巴引流来稳定淋巴水肿的体积。如果患者依从长期治疗,强化阶段后淋巴水肿的体积可能会稳定下来。应给出诸如控制体重和皮肤护理以避免蜂窝织炎等实用建议。对于这种慢性病,需要定期且长期的医学随访以维持患者的积极性。

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