Yamazaki Z, Idezuki Y, Nemoto T, Togawa T
Department of Surgery, University of Tokyo, Japan.
Angiology. 1988 Feb;39(2):154-63. doi: 10.1177/000331978803900205.
A pneumatic massage apparatus has been developed for the treatment of peripheral lymphedema. The stagnant lymph and venous blood are displaced toward the heart by this pneumatic massage. It has been applied to more than 650 patients with edematous limbs in the authors' Hadomer clinic over the last ten years. Satisfactory results were obtained, including decrease in swelling, pain, and induration. The authors' clinical experiences and statistical analysis of the patients are reported here.
9 primary (4 males and 5 females) and 646 secondary (28 males and 618 females) patients with lymphatic edema of extremities have been treated. The majority of the patients had postmastectomy edema of the upper extremity.
The circumference of the edematous limb was measured before and after pneumatic massage treatment of forty to sixty minutes, daily or every second day. (Formula: see text). The rate of swelling was calculated by the formula described above. Twenty-six cases, treated with pneumatic massage for more than fifteen months, have been investigated. A decrease in the rate of swelling was observed in 14 cases (54%), there was no change in 7 (27%), and an increase was seen in 5 (19%). Electric impedance plethysmographic analysis of peripheral lymph volume and blood flow indicated that pneumatic massage was effective in the treatment of edema of the limbs, and its effectiveness was confirmed also by core temperature measurement of the hand during pneumatic massage. The decreased circumference of the edematous limb was kept constant for a long period of time by daily repeated pneumatic massage and ordinary conservative treatments. In conclusion, most lymphedema is of a secondary type. Pneumatic massage was effective in the treatment of peripheral lymph edema, and the improvement was maintained by repeated daily pneumatic massage and ordinary conservative treatment. Therefore, before it becomes worse, lymphedema of the limb should be treated by use of conservative treatments, including pneumatic massage continued as a long-term schedule.
已开发出一种用于治疗周围性淋巴水肿的气动按摩装置。这种气动按摩可将停滞的淋巴液和静脉血推向心脏。在过去十年中，作者所在的哈多默诊所已将其应用于650多名肢体水肿患者。取得了满意的效果，包括肿胀、疼痛和硬结减轻。在此报告作者的临床经验及对患者的统计分析。
已治疗9例原发性（4例男性和5例女性）和646例继发性（28例男性和618例女性）肢体淋巴水肿患者。大多数患者有上肢乳房切除术后水肿。
在每天或隔天进行40至60分钟的气动按摩治疗前后，测量水肿肢体的周长。（公式：见正文）。根据上述公式计算肿胀率。对26例接受气动按摩超过15个月的病例进行了研究。观察到14例（54%）肿胀率下降，7例（27%）无变化，5例（19%）肿胀率上升。外周淋巴容积和血流的电阻抗体积描记分析表明，气动按摩对肢体水肿治疗有效，气动按摩期间手部核心温度测量也证实了其有效性。通过每天重复进行气动按摩和普通保守治疗，水肿肢体周长的减小可长期保持稳定。总之，大多数淋巴水肿为继发性。气动按摩对周围性淋巴水肿治疗有效，通过每天重复进行气动按摩和普通保守治疗可维持改善效果。因此，在肢体淋巴水肿病情恶化之前，应采用保守治疗，包括长期持续进行气动按摩。
