Occupational Therapy Department, Concord Repatriation General Hospital, Sydney, Australia.
Support Care Cancer. 2012 Dec;20(12):3079-86. doi: 10.1007/s00520-012-1433-8. Epub 2012 Mar 13.
This study evaluated the acute effect of massage and compression components of lymphoedema treatment in women with and without arm lymphoedema secondary to breast cancer from a single treatment session.
Women with (n = 15) and without (n = 15) lymphoedema underwent a single session of lymphatic massage. Following the session, women were randomised to receive or not receive a compression sleeve. Measurements were taken prior to, during, and following the massage as well as 30 min after completion of the massage. Bioimpedance spectrometry (BIS) was used to measure changes in extracellular fluid volume of all limbs as well as 10-cm segments within the upper limbs; perometry was used to measure changes in total upper limb volume as well as 10-cm segments within the limb.
There were no significant changes after massage with or without compression. The median (and interquartile range) BIS ratios (unaffected:affected) for the whole upper limb for women with lymphoedema changed from 1.152 (1.053 to 1.422) to 1.192 (1.045 to 1.410) after massage, while the control group changed from 1.024 (0.998 to 1.047) to 1.041 (0.982 to 1.07). The median change in both the BIS ratio and the total arm volume measured with perometry from prior to the massage to following 30-min rest changed <2%, irrespective of whether women used a compression garment and whether women presented with or without lymphoedema. Examination of 10-cm segments within the arm also revealed no significant change in BIS ratio from one segment to the next.
Massage alone or the application of compression after a single session of lymphatic massage was ineffective for reducing lymphoedema.
本研究评估了单次治疗中按摩和压缩成分对乳腺癌继发上肢淋巴水肿妇女和无淋巴水肿妇女的急性影响。
患有（n=15）和不患有（n=15）淋巴水肿的妇女接受单次淋巴按摩。治疗后，患者随机接受或不接受压缩袖套。在按摩前、按摩中、按摩后以及按摩完成后 30 分钟测量测量值。生物电阻抗光谱（BIS）用于测量所有四肢和上肢 10cm 段的细胞外液体积变化；周长计用于测量总上肢体积和上肢 10cm 段的体积变化。
无论是否使用压缩，按摩后均无明显变化。患有淋巴水肿的女性整个上肢的 BIS 比值（未受累/受累）中位数（四分位距）从按摩前的 1.152（1.053-1.422）变为按摩后的 1.192（1.045-1.410），而对照组从 1.024（0.998-1.047）变为 1.041（0.982-1.07）。无论患者是否使用压缩服以及是否患有淋巴水肿，从按摩前到 30 分钟休息后，BIS 比值和周长计测量的总臂体积的中位数变化均<2%。检查臂内的 10cm 段，BIS 比值也无明显变化。
单次淋巴按摩后单独按摩或应用压缩对于减轻淋巴水肿无效。
