Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul, Korea.
Lymphology. 2011 Jun;44(2):72-81.
Lymphedema is swelling of soft tissues by accumulation of lymphatic fluid due to failure of the lymphatic drainage system. Although most measures for lymphedema focus on change of volume or size of the extremity, the physical properties of the tissue such as resistance to compression are also of clinical importance because they affect the quality of life of lymphedema patients. In this study, we aimed to compare the thickness and resistance to compression of the skin and subcutis between the affected and unaffected arms of patients with lymphedema by using ultrasonography together with the compression technique, and we also investigated the factors that have an influence on the results. Thirty-nine patients with post-mastectomy lymphedema participated in this study. All ultrasonographically-assessed thicknesses of skin and subcutaneous tissue in affected upper arms and forearms were significantly larger than the contralateral (p < 0.05) while all resistances to compression values were significantly lower (p < 0.05). These results suggest that measuring the resistance to compression and thickness using the compression method with ultrasonography may be a valuable tool for evaluating lymphedema after breast cancer surgery.
淋巴水肿是由于淋巴引流系统衰竭导致淋巴液在软组织中积聚而引起的肿胀。虽然大多数淋巴水肿的治疗措施都集中在肢体体积或大小的改变上,但组织的物理特性,如抗压性,也具有临床重要性,因为它们会影响淋巴水肿患者的生活质量。在这项研究中,我们旨在通过超声检查结合压迫技术,比较淋巴水肿患者患侧和健侧手臂的皮肤和皮下组织的厚度和抗压性,并研究影响结果的因素。39 名乳腺癌术后淋巴水肿患者参与了本研究。患侧上臂和前臂的皮肤和皮下组织的所有超声评估厚度均明显大于对侧(p<0.05),而所有抗压值均明显降低(p<0.05)。这些结果表明,使用超声检查结合压迫法测量抗压性和厚度可能是评估乳腺癌手术后淋巴水肿的一种有价值的工具。