Yasuhara H, Shigematsu H, Muto T
First Department of Surgery, University of Tokyo, Japan.
Int Angiol. 1996 Sep;15(3):272-7.
To assess the efficacy of compression therapy alone, we report herein the long-term results of leg lymphedema using elastic stockings. Between January 1965 and March 1993, 41 primary lymphedema and 74 secondary lymphedema of the lower extremities have been treated at our hospital. Ten patients had recurrence of cancer, and 5 patients had surgical therapy. The remaining 100 patients were analyzed for the clinical results following treatment with elastic stockings. During the follow-up period of 5 +/- 0.2 years, 3 of 39 limbs (8% or 30 patients) with primary lymphedema wearing elastic stockings experienced enlargement of limb circumference and 36 limbs (92% or 27 patients) showed decrease or no change. Without elastic stockings, 1 out of 13 limbs (8% or 8 patients) with primary lymphedema showed worsening of their symptoms. In contrast, only 1 of 61 limbs (1.7%) in 46 patients with secondary lymphedema who wore elastic stockings showed deterioration of their symptoms. Although elastic stockings did not influence the incidence of the lymphangitis, their effect in maintaining limb circumference was apparent in all the patients with inflammation caused by secondary lymphedema. Among 20 patients with secondary lymphedema who had recurrent lymphangitis, only 1 out of 19 limbs (5%) in 16 patients experienced deterioration of the symptom with the use of elastic stockings while 1 out of 4 limbs (25%) in 4 patients showed improvement or no change without elastic stockings. Our data demonstrate that compression stockings are associated with long-term maintenance of reduced limb circumference, especially in secondary lymphedema regardless of the association with recurrent lymphangitis.
为评估单纯压迫疗法的疗效，我们在此报告使用弹力袜治疗下肢淋巴水肿的长期结果。1965年1月至1993年3月期间，我院共治疗了41例原发性下肢淋巴水肿和74例继发性下肢淋巴水肿患者。10例患者癌症复发，5例患者接受了手术治疗。其余100例患者接受弹力袜治疗后进行了临床结果分析。在5±0.2年的随访期内，39例穿着弹力袜的原发性淋巴水肿患者中有3例（8%，即30例患者）肢体周长增大，36例（92%，即27例患者）肢体周长减小或无变化。未穿弹力袜的13例原发性淋巴水肿患者中有1例（8%，即8例患者）症状恶化。相比之下，46例穿着弹力袜的继发性淋巴水肿患者中，只有61例肢体中的1例（1.7%）症状恶化。尽管弹力袜对淋巴管炎的发生率没有影响，但在所有继发性淋巴水肿引起炎症的患者中，其在维持肢体周长方面的效果是明显的。在20例复发性淋巴管炎的继发性淋巴水肿患者中，16例患者的19例肢体中只有1例（5%）在使用弹力袜时症状恶化，而4例患者的4例肢体中有1例（25%）在未穿弹力袜时症状改善或无变化。我们的数据表明，压迫性弹力袜与长期维持肢体周长缩小有关，尤其是在继发性淋巴水肿中，无论是否伴有复发性淋巴管炎。
