Kitayama Shinya, Maegawa Jiro, Matsubara Shinobu, Kobayashi Shinji, Mikami Taro, Hirotomi Koichi, Kagimoto Shintaro
1 Department of Plastic and Reconstructive Surgery, Yokohama City University School of Medicine , Yokohama, Japan .
2 Department of Plastic and Reconstructive Surgery, Kanagawa Children's Medical Center , Yokohama, Japan .
Lymphat Res Biol. 2017 Mar;15(1):77-86. doi: 10.1089/lrb.2016.0031.
Intermittent pneumatic compression (IPC) is a widely used lymph drainage therapy that can be performed at home. However, the effectiveness of IPC for lymph drainage remains unclear. The aim of this study is to investigate the real-time change in the lymph flow velocity during IPC and consider which mode and pressure are best for treating lower limb lymphedema.
Eight lower left limbs of 8 healthy volunteers and 17 lower limbs of 15 secondary lymphedema patients were investigated. Indocyanine green lymphography was performed with the subject covered with a transparent six-chambered IPC garment. The IPC treatment was administered in several modes (sequential or nonsequential inflation mode, sequential or interrupted deflation mode, and under high or low pressure). Using a brightness intensity analysis software program, the real-time change in the fluorescence intensity during the treatment was recorded and graphed. The maximum inclination of the graph between 2 seconds in the inflation phase (SLOPE) and the mean SLOPE value of all subjects (average SLOPE) were calculated. The average SLOPEs of each mode of treatment were then compared. The average SLOPEs were also compared between patients with mild and moderate lymphedema. There were no significant differences among the SLOPEs in the healthy group. However, in the patient group, the average SLOPE was significantly higher in the sequential inflation mode as well as under high pressure than in the nonsequential inflation mode. On comparing the mild and moderate lymphedema groups, the average SLOPE tended to be higher in the mild group; however, the difference was not statistically significant.
Sequential programs and high pressure resulted in a faster lymphatic flow than other modes. These results suggest that a greater treatment effect could be obtained by adjusting the mode of treatment and the pressure of IPC.
间歇性气动压迫（IPC）是一种广泛应用的可在家中进行的淋巴引流疗法。然而，IPC对淋巴引流的有效性仍不明确。本研究的目的是调查IPC期间淋巴流速的实时变化，并探讨哪种模式和压力最适合治疗下肢淋巴水肿。
对8名健康志愿者的8条左下肢和15名继发性淋巴水肿患者的17条下肢进行了研究。让受试者穿着透明的六腔IPC服装进行吲哚菁绿淋巴造影。以几种模式进行IPC治疗（顺序或非顺序充气模式、顺序或间断放气模式以及高压或低压）。使用亮度强度分析软件程序，记录并绘制治疗期间荧光强度的实时变化。计算充气阶段2秒内图表的最大倾斜度（斜率）以及所有受试者的平均斜率值（平均斜率）。然后比较每种治疗模式的平均斜率。还比较了轻度和中度淋巴水肿患者之间的平均斜率。健康组的斜率之间无显著差异。然而，在患者组中，顺序充气模式以及高压下的平均斜率显著高于非顺序充气模式。比较轻度和中度淋巴水肿组时，轻度组的平均斜率往往更高；然而，差异无统计学意义。
顺序程序和高压导致淋巴流动比其他模式更快。这些结果表明，通过调整治疗模式和IPC压力可获得更大的治疗效果。
