淋巴水肿的非手术治疗
Nonoperative Treatment of Lymphedema.
作者信息
Schaverien Mark V, Moeller Julie A, Cleveland Sarah D
机构信息
Department of Plastic Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas.
Department of Rehabilitation Services, University of Texas MD Anderson Cancer Center, Katy Regional Care Center, Houston, Texas.
出版信息
Semin Plast Surg. 2018 Feb;32(1):17-21. doi: 10.1055/s-0038-1635119. Epub 2018 Apr 9.
Abstract
Complex decongestive therapy is the mainstay of lymphedema (LE) therapy. It consists of two phases: an intensive volume reduction phase, principally involving low-stretch bandages and manual lymph drainage (MLD), followed by compression garment use to maintain the reduction achieved. Adjunctive treatments include the use of a sequential gradient pump, LE-specific exercises, skin and nail care, as well as risk-reduction precautions. Herein the techniques are described and the evidence for their effectiveness is reviewed.
摘要
综合消肿疗法是淋巴水肿（LE）治疗的主要方法。它包括两个阶段：一个强化的容积减少阶段，主要涉及低弹性绷带和手法淋巴引流（MLD），随后使用压力衣来维持所达到的消肿效果。辅助治疗包括使用序贯梯度泵、针对淋巴水肿的特定锻炼、皮肤和指甲护理以及降低风险的预防措施。本文将描述这些技术，并综述其有效性的证据。
相似文献
1
Nonoperative Treatment of Lymphedema.淋巴水肿的非手术治疗
Semin Plast Surg. 2018 Feb;32(1):17-21. doi: 10.1055/s-0038-1635119. Epub 2018 Apr 9.
2
[Management of lymphedema of the upper extremity after treatment of breast cancer].[乳腺癌治疗后上肢淋巴水肿的管理]
Bull Cancer. 2007 Jul;94(7):669-74.
3
Management of lymphedema.淋巴水肿的管理。
Dermatol Ther. 2012 Jul-Aug;25(4):352-7. doi: 10.1111/j.1529-8019.2012.01534.x.
4
[Treatment of limbs lymphedema].[肢体淋巴水肿的治疗]
Presse Med. 2010 Dec;39(12):1315-23. doi: 10.1016/j.lpm.2009.12.011. Epub 2010 Sep 17.
5
Long-term management of breast cancer-related lymphedema after intensive decongestive physiotherapy.强化消肿物理治疗后乳腺癌相关淋巴水肿的长期管理
Breast Cancer Res Treat. 2007 Mar;101(3):285-90. doi: 10.1007/s10549-006-9297-6. Epub 2006 Jul 7.
6
Lymphedema: a therapeutic approach in the treatment and rehabilitation of cancer patients.淋巴水肿：癌症患者治疗和康复的治疗方法。
Am J Phys Med Rehabil. 2011 May;90(5 Suppl 1):S69-75. doi: 10.1097/PHM.0b013e31820be160.
7
Complex Decongestive Lymphatic Therapy With or Without Vodder II Manual Lymph Drainage in More Severe Chronic Postmastectomy Upper Limb Lymphedema: A Randomized Noninferiority Prospective Study.复杂消肿淋巴治疗联合或不联合沃德尔 II 手法淋巴引流治疗更严重的慢性乳腺癌术后上肢淋巴水肿：一项随机非劣效性前瞻性研究。
J Pain Symptom Manage. 2015 Dec;50(6):750-7. doi: 10.1016/j.jpainsymman.2015.06.017. Epub 2015 Aug 22.
8
Manipulative therapy of secondary lymphedema in the presence of locoregional tumors.局部区域肿瘤存在时继发性淋巴水肿的手法治疗
Cancer. 2008 Feb 15;112(4):950-4. doi: 10.1002/cncr.23242.
9
Reduction of lymphedema using complete decongestive therapy: roles of prior radiation therapy and extent of axillary dissection.使用完全减压疗法减轻淋巴水肿：既往放疗和腋窝清扫范围的作用。
J Soc Integr Oncol. 2007 Summer;5(3):87-91. doi: 10.2310/7200.2007.004.
10
Protocol of a randomised controlled trial regarding the effectiveness of fluoroscopy-guided manual lymph drainage for the treatment of breast cancer-related lymphoedema (EFforT-BCRL trial).关于荧光透视引导下手法淋巴引流治疗乳腺癌相关淋巴水肿有效性的随机对照试验方案（EFforT-BCRL试验）
Eur J Obstet Gynecol Reprod Biol. 2018 Feb;221:177-188. doi: 10.1016/j.ejogrb.2017.12.023. Epub 2017 Dec 16.
引用本文的文献
1
Lipedema: Clinical Features, Diagnosis, and Management.脂肪性水肿：临床特征、诊断与管理
Arch Plast Surg. 2025 May 15;52(3):185-196. doi: 10.1055/a-2530-5875. eCollection 2025 May.
2
Advances in surgical management of chronic lymphedema: current strategies and future directions.慢性淋巴水肿外科治疗进展：当前策略与未来方向
Med Oncol. 2025 Jan 13;42(2):44. doi: 10.1007/s12032-024-02576-2.
3
Obesity-Associated Breast Cancer: Analysis of Risk Factors and Current Clinical Evaluation.肥胖相关性乳腺癌：危险因素分析与临床评估现状。
Adv Exp Med Biol. 2024;1460:767-819. doi: 10.1007/978-3-031-63657-8_26.
4
Demystifying vascularized lymph node transfers and lymphatico-venous anastomoses.揭秘带血管蒂淋巴结转移术及淋巴管-静脉吻合术
Ann Transl Med. 2024 Feb 1;12(1):8. doi: 10.21037/atm-23-132. Epub 2023 Jul 10.
5
Non-Linear Lymphatic Anatomy in Breast Cancer Patients Prior to Axillary Lymph Node Dissection: A Risk Factor For Lymphedema Development.乳腺癌患者腋窝淋巴结清扫术前非线性淋巴解剖：淋巴水肿发生的危险因素。
J Mammary Gland Biol Neoplasia. 2023 Jul 22;28(1):20. doi: 10.1007/s10911-023-09545-x.
6
Effectiveness of Mobiderm Autofit in the Intensive Phase of Breast Cancer-Related Lymphedema Treatment: A Case Series.MobiDerm Autofit 在乳腺癌相关淋巴水肿强化治疗阶段的有效性：病例系列研究。
Lymphat Res Biol. 2023 Dec;21(6):608-613. doi: 10.1089/lrb.2022.0079. Epub 2023 May 22.
7
Lipedema: Insights into Morphology, Pathophysiology, and Challenges.脂肪性水肿：对形态学、病理生理学及挑战的见解
Biomedicines. 2022 Nov 30;10(12):3081. doi: 10.3390/biomedicines10123081.
8
Surgical Treatment and Rehabilitation Strategies for Upper and Lower Extremity Lymphedema: A Comprehensive Review.上肢和下肢淋巴水肿的手术治疗和康复策略：全面综述。
Medicina (Kaunas). 2022 Jul 19;58(7):954. doi: 10.3390/medicina58070954.
9
Intensive complex physical therapy combined with intermittent pneumatic compression versus Kinesio taping for treating breast cancer-related lymphedema of the upper limb: A randomised cross-over clinical trial.强化综合物理治疗联合间歇性气动压迫与肌内效贴治疗乳腺癌相关上肢淋巴水肿的随机交叉临床试验。
Eur J Cancer Care (Engl). 2022 Sep;31(5):e13625. doi: 10.1111/ecc.13625. Epub 2022 May 31.
10
Standard of care for lipedema in the United States.美国脂性水肿的护理标准。
Phlebology. 2021 Dec;36(10):779-796. doi: 10.1177/02683555211015887. Epub 2021 May 28.
本文引用的文献
1
Association Between Precautionary Behaviors and Breast Cancer-Related Lymphedema in Patients Undergoing Bilateral Surgery.双侧手术患者的预防行为与乳腺癌相关淋巴水肿之间的关联
J Clin Oncol. 2017 Dec 10;35(35):3934-3941. doi: 10.1200/JCO.2017.73.7494. Epub 2017 Oct 4.
2
Considerations for Clinicians in the Diagnosis, Prevention, and Treatment of Breast Cancer-Related Lymphedema, Recommendations from an Expert Panel: Part 2: Preventive and Therapeutic Options.临床医生对乳腺癌相关淋巴水肿的诊断、预防和治疗的考量，专家小组建议：第2部分：预防和治疗选择
Ann Surg Oncol. 2017 Oct;24(10):2827-2835. doi: 10.1245/s10434-017-5964-6. Epub 2017 Aug 1.
3
Precautions for breast cancer-related lymphoedema: risk from air travel, ipsilateral arm blood pressure measurements, skin puncture, extreme temperatures, and cellulitis.乳腺癌相关淋巴水肿的预防：航空旅行、同侧手臂血压测量、皮肤穿刺、极端温度和蜂窝织炎带来的风险。
Lancet Oncol. 2016 Sep;17(9):e392-405. doi: 10.1016/S1470-2045(16)30204-2. Epub 2016 Aug 30.
4
Impact of Ipsilateral Blood Draws, Injections, Blood Pressure Measurements, and Air Travel on the Risk of Lymphedema for Patients Treated for Breast Cancer.同侧采血、注射、血压测量及航空旅行对乳腺癌治疗患者淋巴水肿风险的影响。
J Clin Oncol. 2016 Mar 1;34(7):691-8. doi: 10.1200/JCO.2015.61.5948. Epub 2015 Dec 7.
5
The effectiveness of intermittent pneumatic compression in long-term therapy of lymphedema of lower limbs.间歇性气动压迫在下肢淋巴水肿长期治疗中的有效性。
Lymphat Res Biol. 2014 Jun;12(2):103-9. doi: 10.1089/lrb.2013.0033.
6
Complementary, alternative, and other noncomplete decongestive therapy treatment methods in the management of lymphedema: a systematic search and review.辅助、替代及其他非完全性消肿治疗方法在淋巴水肿管理中的应用：系统检索与综述
PM R. 2014 Mar;6(3):250-74; quiz 274. doi: 10.1016/j.pmrj.2013.09.008. Epub 2013 Sep 18.
7
Randomized trial of decongestive lymphatic therapy for the treatment of lymphedema in women with breast cancer.一项针对乳腺癌女性淋巴水肿治疗的充血性淋巴治疗的随机试验。
J Clin Oncol. 2013 Oct 20;31(30):3758-63. doi: 10.1200/JCO.2012.45.7192. Epub 2013 Sep 16.
8
Pneumatic compression device treatment of lower extremity lymphedema elicits improved limb volume and patient-reported outcomes.气动压迫装置治疗下肢淋巴水肿可改善肢体容积和患者报告的结局。
Eur J Vasc Endovasc Surg. 2013 Oct;46(4):480-7. doi: 10.1016/j.ejvs.2013.07.012. Epub 2013 Aug 21.
9
10
A systematic review of the evidence for complete decongestive therapy in the treatment of lymphedema from 2004 to 2011.2004 年至 2011 年完整消肿疗法治疗淋巴水肿的证据系统评价。
PM R. 2012 Aug;4(8):580-601. doi: 10.1016/j.pmrj.2012.05.003.
Zotero 插件