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多层压力包扎治疗难治性外周水肿的改善:病例报告。

Improvement of Refractory Peripheral Edema With Multilayered Compression Bandaging: A Case Report.

机构信息

Department of Palliative, Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1414, Houston, TX 77030 (USA).

Department of Palliative, Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center.

出版信息

Phys Ther. 2018 Sep 1;98(9):763-766. doi: 10.1093/ptj/pzy072.

Abstract

BACKGROUND AND PURPOSE

Lower extremity edema, which can be caused by several factors, is often poorly managed with commonly prescribed compression stockings and diuretics. Diuretics are often erroneously given in all forms of edema and may cause problems because their long-term application may induce chronicity of the edema due to disturbance of the renin-angiotensin relationship. Compression therapy, although effective against venous edema, is widely underused.

CASE DESCRIPTION

A 64-year-old man with a history of hypertension, coronary artery disease, psoriasis, and multiple myeloma was admitted to the hospital for neutropenic fever, right lower extremity (RLE) cellulitis, bilateral lower extremity (BLE) weakness, RLE pain, and significant BLE edema. The patient was referred to a lymphedema-certified therapist to apply lower extremity multilayered compression bandaging and document serial limb circumference measurements.

OUTCOMES

The patient's weight decreased from 94.5 kg on day 1 of compression bandaging to 86.3 kg on day 7. The circumferences of the affected limbs also decreased.

DISCUSSION

This case demonstrates the utility of multilayered compression bandaging, typically used in the management of lymphedema, in the control of peripheral edema that is refractory to diuretic therapy.

摘要

背景与目的

下肢水肿可由多种因素引起,常采用加压袜和利尿剂进行常规治疗,但效果不佳。利尿剂常被错误地用于所有类型的水肿,可能会导致问题,因为长期应用可能会由于肾素-血管紧张素关系紊乱而导致水肿的慢性化。尽管加压治疗对静脉性水肿有效,但应用广泛不足。

病例描述

一名 64 岁男性,既往有高血压、冠状动脉疾病、银屑病和多发性骨髓瘤病史,因中性粒细胞减少性发热、右下肢体(RLE)蜂窝织炎、双侧下肢(BLE)无力、RLE 疼痛和明显的 BLE 水肿而住院。患者被转诊至淋巴水肿认证治疗师,以应用下肢多层压缩绷带包扎,并记录连续的肢体周径测量。

结果

患者的体重从接受压缩绷带包扎的第 1 天的 94.5kg 下降到第 7 天的 86.3kg。受影响肢体的周径也有所减少。

讨论

本病例证明了多层压缩绷带包扎在治疗利尿剂难治性周围水肿中的应用价值,这种方法通常用于治疗淋巴水肿。

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