Mirolo B R, Bunce I H, Chapman M, Olsen T, Eliadis P, Hennessy J M, Ward L C, Jones L C
Wesley Clinic for Haematology and Oncology, Wesley Medical Centre, Brisbane, Australia.
Cancer Nurs. 1995 Jun;18(3):197-205.
The effect of a comprehensive lymphedema management program was assessed in 25 patients in whom moderate to severe lymphedema had developed after surgery and/or radiotherapy for carcinoma of the breast. Intensive treatment (4 weeks) involved massage, compression bandaging, and sequential pneumatic compression, with an adjunct program of education to provide skills in exercise, massage, bandage, and containment garment use. The intensive treatment phase was followed by a self-management phase based on the skills that had been acquired. A significant reduction in limb circumference and volume, with continuing improvement over 12 months of self-management, was observed. There was a decrease in need for physical assistance. Quality of life generally remained high and stable throughout the 12 months. Quality of life specific to lymphedema, however, declined during the intensive phase of treatment, but recovered and surpassed pretreatment levels during the self-management phase of treatment. Perceived comfort and strength in the lymphedematous limb improved, and perceived size decreased. The study confirmed that the combination of multimodal physical therapy and education for self-management reduces lymphedema and its adverse subjective consequences and maintains the improvement thus achieved.
对25例因乳腺癌手术和/或放疗后出现中度至重度淋巴水肿的患者评估了综合淋巴水肿管理方案的效果。强化治疗（4周）包括按摩、加压包扎和序贯气压治疗，并辅以教育方案，以教授运动、按摩、包扎和使用弹力衣的技巧。强化治疗阶段之后是基于所学技巧的自我管理阶段。观察到肢体周长和体积显著减小，且在12个月的自我管理期间持续改善。对身体协助的需求减少。在整个12个月中，生活质量总体保持较高且稳定。然而，淋巴水肿特异性生活质量在强化治疗阶段下降，但在自我管理治疗阶段恢复并超过治疗前水平。淋巴水肿肢体的舒适度和力量感得到改善，且感觉尺寸减小。该研究证实，多模式物理治疗与自我管理教育相结合可减轻淋巴水肿及其不良主观后果，并维持所取得的改善效果。
