Sarri Almir José, Moriguchi Sonia Marta, Dias Rogério, Peres Stela Verzinhasse, DA Silva Eduardo Tinóis, Koga Kátia Hiromoto, Zucca Matthes Angelo Gustavo, Dos Santos Marcelo José, DA Rocha Euclides Timóteo, Haikel Raphael Luiz
Departments of Physiotherapy.
Exp Ther Med. 2010 Jan;1(1):147-152. doi: 10.3892/etm_00000024. Epub 2010 Jan 1.
The aim of this study was to confirm the effectiveness of early physiotherapeutic stimulation for lymphatic flow progression in patients with breast cancer undergoing axillary dissection. This was a randomized experimental study on 22 patients who underwent lymphoscintigraphy in their arms on two different occasions, firstly without stimulation and secondly after randomization into two groups: without physiotherapeutic stimulation (WOPS; n=10) and with physiotherapeutic stimulation (WPS; n=12). The lymphoscintigraphy scan was performed with (99m)Tc-phytate administered into the second interdigital space of the hand, ipsilaterally to the dissected axilla, in three phases: dynamic, static, and delayed whole body imaging. Physiotherapeutic stimulation was carried out using Földi's technique. In both groups, images from the two examinations of each patient were compared. Flow progression was considered positive when, on the second examination, the radiopharmaceutical reached areas more distant from the injection site. Statistical analysis was used to evaluate frequencies, percentages and central trend measurements, and non-parametric tests were conducted. Descriptive analysis showed that the WPS and WOPS groups were similar in terms of mean age, weight, height, body mass index and number of lymph nodes removed. There were statistically significant associations between physiotherapeutic stimulation and radiopharmaceutical progression at all three phases of the study (p<0.0001). Early physiotherapeutic stimulation in breast cancer patients undergoing radical axillary dissection is effective, and can therefore be indicated as a preventive measure against lymphedema.
本研究的目的是证实早期物理治疗刺激对接受腋窝清扫术的乳腺癌患者淋巴液流动进展的有效性。这是一项针对22例患者的随机实验研究，这些患者在两个不同时间点接受了手臂淋巴闪烁造影检查，首先是在无刺激的情况下，其次是在随机分为两组后：无物理治疗刺激组（WOPS；n = 10）和有物理治疗刺激组（WPS；n = 12）。淋巴闪烁造影扫描是通过将（99m）锝 - 植酸盐注入患侧腋窝对应的手部第二指间间隙进行的，分三个阶段：动态、静态和延迟全身显像。物理治疗刺激采用福尔迪技术。在两组中，对每位患者两次检查的图像进行了比较。当在第二次检查时放射性药物到达距离注射部位更远的区域时，淋巴液流动进展被认为是阳性的。采用统计分析来评估频率、百分比和集中趋势测量，并进行了非参数检验。描述性分析表明，WPS组和WOPS组在平均年龄、体重、身高、体重指数和切除的淋巴结数量方面相似。在研究的所有三个阶段，物理治疗刺激与放射性药物进展之间均存在统计学显著关联（p<0.0001）。对接受根治性腋窝清扫术的乳腺癌患者进行早期物理治疗刺激是有效的，因此可作为预防淋巴水肿的一项措施。
