Department of Plastic, Hand and Reconstructive Surgery, University Hospital Regensburg, Regensburg, Germany.
Center for Clinical Studies, University Hospital Regensburg, Regensburg, Germany.
Lymphat Res Biol. 2020 Dec;18(6):549-554. doi: 10.1089/lrb.2019.0094. Epub 2020 Apr 6.
The influence of pulsed electromagnetic field therapy (PEMFT) on medium-sized vessels as well as capillary microcirculation is well known. Effects on lymphatic vessels, however, are difficult to visualize and have not been investigated to date. One of the operative treatment options in primary and secondary lymphedemas is lymphovenous anastomoses using supermicrosurgery. To prove patency of the anastomosis, the lymphatic flow is visualized by fluorescence using indocyanine green. The aim of this study was to investigate the influence of PEMFT on the lymphatic microcirculation, and compare it with conventional manual lymphatic drainage (MLD) during supermicrosurgery. Ten patients with lymphedema were included. Indocyanine green was injected before the operation for intraoperative visualization of the lymphatic vessels using a microscope equipped with an integrated near-infrared illumination system (Zeiss). The PEMFT system (Bio-Electro-Magnetic-Energy Regulation [BEMER]) was used as our standard device during a single 2-minute application period (AP) followed by MLD or vice versa. The mean light intensity in the calibration period (CP) was 46.53 ± 24.3 and 33.41 ± 12.92 for PEMFT and MLD, respectively. During the AP, the mean light intensity changed to 45.61 ± 24.40 for PEMFT and 57.05 ± 18.80 during MLD. This change between CP and AP did not differ significantly for the PEMFT application ( = 0.26), but showed an increase in light intensity during MLD ( < 0.001). We found a light intensity enhancement equivalent to a flow increase during MLD of 78.7% ± 45.7% (range 20%-144%) and no significant difference during the PEMFT application. A single period application of PEMFT did not affect the lymphatic flow.
脉冲电磁场治疗（PEMFT）对中血管和毛细血管微循环的影响是众所周知的。然而，其对淋巴管的影响很难可视化，迄今为止尚未对此进行研究。原发性和继发性淋巴水肿的一种手术治疗选择是使用超显微外科进行淋巴管静脉吻合术。为了证明吻合口通畅，使用吲哚菁绿通过荧光使淋巴液可视化。本研究旨在探讨 PEMFT 对淋巴微循环的影响，并将其与超显微外科手术中的常规手动淋巴引流（MLD）进行比较。 纳入了 10 例淋巴水肿患者。在手术前注射吲哚菁绿，以便使用配备集成近红外照明系统（蔡司）的显微镜对淋巴管进行术中可视化。PEMFT 系统（生物电磁能量调节[BEMER]）是我们的标准设备，在单次 2 分钟应用期（AP）后使用，然后是 MLD 或反之亦然。CP 期间的平均光强度为 46.53 ± 24.3，PEMFT 和 MLD 分别为 33.41 ± 12.92。在 AP 期间，PEMFT 的平均光强度变为 45.61 ± 24.40，而 MLD 的平均光强度变为 57.05 ± 18.80。PEMFT 应用期间 CP 和 AP 之间的这种变化没有显著差异（ = 0.26），但在 MLD 期间光强度增加（ < 0.001）。 我们发现，在 MLD 期间，光强度增强相当于流量增加 78.7% ± 45.7%（范围 20%-144%），而在 PEMFT 应用期间没有显著差异。单次 PEMFT 应用不会影响淋巴流量。
