University Medical of São Jose do Rio Preto-FAMERP-Brazil Cardiology and Vascular Surgery Rua Floriano Peixoto São Jose do Rio Preto, Brazil.
Eur J Intern Med. 2013 Jan;24(1):59-62. doi: 10.1016/j.ejim.2012.08.008. Epub 2012 Sep 7.
The aim of this study was to evaluate a new form of intensive treatment for arm lymphedema.
A prospective study of 66 patients with breast cancer-related lymphedema was performed. The ages of the patients ranged from 35 to 83 years old with a mean of 58.8 years. Diagnosis of lymphedema was made by physical examination and water-displacement volumetry (a difference of ≥ 200 mL between arms). All the patients were submitted to clinical treatment in an outpatient setting which involved a once-weekly session of 3 to 4h of manual and mechanical lymph drainage, myolymphokinetic activities and exercising using facilitating apparatuses and the use of a medical compression sleeve. Monthly volumetry evaluations were routinely performed. The Student t-test was employed for statistical analysis with an alpha level of 5% (p<0.05) being considered significant.
The mean follow-up time between cancer treatment and this study was 12.3 months. A significant reduction in the size of the arms was observed for all patients. The mean difference between the lymphedematous and normal arms of all patients was 553.8 mL at the start of treatment and a mean reduction of 70.1% (388.7 mL) of the edema was achieved (p=0.0001).
In our experience, this model of treatment appeared efficacious in decreasing and maintaining the reduction in volume of arm in breast cancer-related lymphedema.
本研究旨在评估一种新的手臂淋巴水肿强化治疗形式。
对 66 例乳腺癌相关淋巴水肿患者进行了前瞻性研究。患者年龄 35 至 83 岁，平均 58.8 岁。通过体格检查和水置换容积测量（手臂之间差异≥200ml）诊断淋巴水肿。所有患者均在门诊接受临床治疗，每周一次，每次 3 至 4 小时，包括手动和机械淋巴引流、肌淋巴动力学活动、使用促进设备进行锻炼以及使用医疗压缩袖套。每月进行容积评估。采用学生 t 检验进行统计学分析，以 5%的显著水平（p<0.05）。
从癌症治疗到本研究的平均随访时间为 12.3 个月。所有患者手臂大小均明显缩小。所有患者淋巴水肿臂与正常臂的平均差值为 553.8ml，治疗后平均减少 70.1%（388.7ml）（p=0.0001）。
根据我们的经验，这种治疗模式在减少和维持乳腺癌相关淋巴水肿手臂体积减少方面似乎是有效的。
