Takeno Yukari, Arita Hiromi, Fujimoto Etsuko
Graduate School of medicine, Nagoya University, 1-1-20 Daiko- Minami, Higashi-Ku, Nagoya-Shi, Aichi-Ken, 461-0047 Japan.
Springerplus. 2013 May 16;2(1):225. doi: 10.1186/2193-1801-2-225. Print 2013 Dec.
Although complete decongestive therapy (CDT) is considered to reduce the volume of lymphedema, there is no concrete evidence to sustain its efficacy. The purpose of the present study was to find new evidence of CDT based on visualizing the changes of lymph fluid accumulating in an edematous limb using indocyanine green (ICG) fluorescent lymphography in real time.Twelve lymphedema rats were divided randomly into two groups. On the first day, ICG was injected into an edematous limb of rats, and no-intervention and CDT was applied to groups 1 and 2, respectively, for two weeks. ICG lymphography and circumferential measurements were done every two days in each two-week observation. The results indicates that a fluorescent flow to the ipsilateral axillary fossa was identified in all rats. In addition, network-like and dermal backflow patterns were observed in the lower legs and thighs. While manual lymph drainage was applied in the CDT group, the flow moved more rapidly through this pathway than that in the no-intervention group. An area of high-intensity fluorescent signals concentrated around the injection sites diminished in the CDT group more than that in the no-intervention-group after two weeks. Circumferential lengths of the edematous limbs were longer than the non-edematous limbs in both groups 1 and 2 on the day of ICG injection. The no-intervention group 1 showed no significance differences during 14 days, whereas the CDT group 2 exhibited very significant differences. These results suggest that CDT has beneficial effects in lymphedema treatment.
尽管完全减压疗法（CDT）被认为可减少淋巴水肿的体积，但尚无确凿证据支持其疗效。本研究的目的是通过使用吲哚菁绿（ICG）荧光淋巴造影实时观察水肿肢体中积聚的淋巴液变化，来寻找CDT的新证据。12只淋巴水肿大鼠被随机分为两组。第一天，将ICG注入大鼠的水肿肢体，第1组和第2组分别进行无干预和CDT治疗，为期两周。在每两周的观察期内，每两天进行一次ICG淋巴造影和周长测量。结果表明，在所有大鼠中均发现荧光流向同侧腋窝。此外，在小腿和大腿观察到网状和真皮逆流模式。在CDT组进行手法淋巴引流时，淋巴液通过该途径的流动比无干预组更快。两周后，CDT组注射部位周围高强度荧光信号的区域比无干预组减少得更多。在ICG注射当天，第1组和第2组水肿肢体的周长均长于非水肿肢体。第1组无干预组在14天内无显著差异，而第2组CDT组则表现出非常显著的差异。这些结果表明，CDT在淋巴水肿治疗中具有有益作用。
