Department of Science and Research, Centre for Palliative Medicine, University of Bonn, Bonn, Germany.
Jpn J Clin Oncol. 2010 Nov;40(11):1068-72. doi: 10.1093/jjco/hyq093. Epub 2010 Jun 17.
Lymphoedema is a common sequela of cancer or its treatment that affects lymph node drainage. The physiotherapist, as member of the multiprofessional team in palliative care, is one of the keys to successful rehabilitation and management of patients with cancer and non-malignant motoneuron disease such as amyotrophic lateral sclerosis and palliative care needs. The aim of the study was to evaluate the frequency and effect of manual lymphatic drainage in palliative care patients with lymphoedema in a far advanced stage of their disease.
Retrospective study (reflexive control design) of data of the 208 patients admitted to our palliative care unit from January 2007 to December 2007. Demographic and disease-related data (diagnosis, symptoms, Karnofsky performance status and effect of manual lymphatic drainage interventions) were documented and compared.
mean ± SD, median; Wilcoxon's test.
Of the 208 patients, 90 who reported symptom load due to lymphoedema were included; 67 (74.4%) had pain, 23 (25.6%) dyspnoea due to progredient trunk oedema. Mean age 65.5 ± 13.0 years; 33 (36.7%) male; Karnofsky index 50% (30-80%), mean length of stay 15.6 ± 8.0 days. The mean number of physiotherapeutic treatment interventions was 7.0 ± 5.8. Manual lymphatic drainage was well tolerated in 83 (92.2%) patients; 63 of 67 (94.0%) patients showed a clinically relevant improvement in pain, and 17 of 23 (73.9%) in dyspnoea.
The majority of the patients showed a clinical improvement in the intensity of symptoms after manual lymphatic drainage.
淋巴水肿是癌症或其治疗的常见后遗症，会影响淋巴结引流。理疗师作为姑息治疗多学科团队的一员，是成功康复和管理癌症患者以及非恶性运动神经元疾病（如肌萎缩侧索硬化症和姑息治疗需求）患者的关键之一。本研究旨在评估在疾病晚期处于非常严重阶段的姑息治疗患者中，手动淋巴引流的频率和效果。
对 2007 年 1 月至 2007 年 12 月期间入住我们姑息治疗病房的 208 名患者的数据进行回顾性研究（反思性对照设计）。记录人口统计学和疾病相关数据（诊断、症状、卡诺夫斯基表现状态和手动淋巴引流干预的效果）并进行比较。
均值±标准差，中位数；Wilcoxon 检验。
208 名患者中有 90 名报告因淋巴水肿引起的症状负荷，其中 67 名（74.4%）有疼痛，23 名（25.6%）因进展性躯干水肿而呼吸困难。平均年龄 65.5±13.0 岁；33 名（36.7%）男性；卡诺夫斯基指数 50%（30-80%），平均住院时间 15.6±8.0 天。理疗治疗干预的平均次数为 7.0±5.8。83 名（92.2%）患者能很好地耐受手动淋巴引流；67 名患者中的 63 名（94.0%）疼痛程度有临床相关改善，23 名患者中的 17 名（73.9%）呼吸困难有改善。
大多数患者在接受手动淋巴引流后症状强度有临床改善。
