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淋巴水肿减压治疗疗效的预测因素

Predictors of the Efficacy of Lymphedema Decongestive Therapy.

作者信息

Dzupina Andrej, Yaluri Nagendra, Singh Jaipaul, Jankajova Monika

机构信息

Department of Angiology, National Heart Institute, 833 48 Bratislava, Slovakia.

Centre of Clinical and Preclinical Research MEDIPARK, Pavol Jozef Safarik University, 040 01 Kosice, Slovakia.

出版信息

Medicina (Kaunas). 2025 Jan 27;61(2):231. doi: 10.3390/medicina61020231.

Abstract

Lymphedema is a chronic condition characterized by the accumulation of lymphatic fluid in the tissues, causing swelling primarily in the limbs, though other body parts can also be affected. It commonly develops after lymph node removal, or radiation therapy, or due to congenital lymphatic system defects. Effective management is essential due to its significant impact on physical function and quality of life. Complete Decongestive Therapy (CDT) is the primary treatment for lymphedema. This comprehensive approach combines manual lymphatic drainage (MLD), compression bandaging, skincare, and exercise. An early diagnosis and initiation of CDT are critical to preventing irreversible damage to the lymphatic system and worsening symptoms. Successful outcomes depend on timely treatment, patient adherence, and the consistent use of all CDT components, with compression therapy and exercise playing particularly vital roles. Recent research highlights how skin and fat tissue characteristics, such as increased skin thickness and adipose tissue accumulation, complicate lymphedema management, especially in advanced stages. In these cases, where fibrosis and fat deposition are more prominent, traditional CDT may need to be supplemented with advanced treatments like liposuction or enhanced compression techniques. This study explores the factors influencing the success of decongestive therapy, including the stage of lymphedema at the diagnosis, treatment protocols, and individual patient characteristics like skin and fat tissue properties.

摘要

淋巴水肿是一种慢性疾病,其特征是组织中淋巴液积聚,主要导致四肢肿胀,不过身体其他部位也可能受到影响。它通常在淋巴结切除、放射治疗后发生,或由于先天性淋巴系统缺陷所致。由于其对身体功能和生活质量有重大影响,有效的管理至关重要。完全减压疗法(CDT)是淋巴水肿的主要治疗方法。这种综合方法结合了手法淋巴引流(MLD)、加压包扎、皮肤护理和运动。早期诊断并开始CDT对于预防淋巴系统不可逆转的损伤和症状恶化至关重要。成功的治疗效果取决于及时治疗、患者的依从性以及持续使用所有CDT组件,其中加压疗法和运动起着尤为重要的作用。最近的研究强调,皮肤和脂肪组织特征,如皮肤厚度增加和脂肪组织堆积,会使淋巴水肿的管理复杂化,尤其是在晚期。在这些纤维化和脂肪沉积更为突出的病例中,传统的CDT可能需要辅以抽脂或强化加压技术等先进治疗方法。本研究探讨了影响减压疗法成功的因素,包括诊断时淋巴水肿的阶段、治疗方案以及个体患者特征,如皮肤和脂肪组织特性。

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