Do Junghwa, Jeon JaeYong, Kim Won
Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Republic of Korea.
J Phys Ther Sci. 2017 Jul;29(7):1272-1275. doi: 10.1589/jpts.29.1272. Epub 2017 Jul 15.
[Purpose] The purpose of this case study was to determine the effectiveness of bandaging the arm of a patient with secondary lymphedema on the patient's quality of life, arm volume and arm function using an additional pad and taping along with some other standard therapy modalities for lymphedema. [Subjects and Methods] I used a bandage with an additional pad and taping, along with MLD, exercise, and skin care to treat a patient with unilateral breast-cancer-related arm lymphedema who had fibrotic tissue on her lower arm and hand. I made a pad called a "muff" and applied it under tape while using Vodder's technique. Treatment was performed during 5 therapy sessions a week for 2 weeks. [Results] After the physiotherapy sessions, the excess edema volume decreased to 608 ml, and the percentage of excess volume (PEV) was 9.6%. The therapeutic efficacy, measured as percentage reduction of excess volume (PREV), was -79.5%, meaning that the edema volume was reduced 79.5%. The use of an additional pad and taping on a large edematous site with fibrotic changes can produce more efficacious lymphedema care. [Conclusion] The use of an additional pad and taping on a large edematous site with fibrotic changes has demonstrated a positive result in lymphedema management for a post mastectomy patient and, therefore, further studies on this method are suggested with a larger sample size.
[目的] 本病例研究的目的是确定使用额外的衬垫和绷带包扎继发淋巴水肿患者的手臂,同时结合其他一些标准的淋巴水肿治疗方式,对患者生活质量、手臂体积和手臂功能的影响。[对象与方法] 我使用带有额外衬垫和绷带的包扎方法,结合手法淋巴引流(MLD)、运动和皮肤护理,来治疗一名患有单侧乳腺癌相关手臂淋巴水肿且前臂和手部存在纤维化组织的患者。我制作了一个名为“袖套”的衬垫,并在使用沃德尔技术时将其置于绷带下。每周进行5次治疗,持续2周。[结果] 物理治疗疗程结束后,多余水肿体积降至608 ml,多余体积百分比(PEV)为9.6%。以多余体积减少百分比(PREV)衡量的治疗效果为 -79.5%,这意味着水肿体积减少了79.5%。在有纤维化改变的大水肿部位使用额外的衬垫和绷带包扎可产生更有效的淋巴水肿护理效果。[结论] 在有纤维化改变的大水肿部位使用额外的衬垫和绷带包扎,已在乳房切除术后患者的淋巴水肿管理中显示出积极效果,因此建议以更大样本量对该方法进行进一步研究。