Ferrandez J C, Laroche J P, Serin D, Felix-Faure C, Vinot J M
Unité de Rééducation Vasculaire et Rééducation Main Membre Supérieur, Avignon.
J Mal Vasc. 1996;21(5):283-9.
Manual lymphatic drainage is used in physiotherapy of limb lymphedema in combination with other physical techniques. In order to assess the effectiveness of the method, 47 patients with upper limb lymphedema after radiosurgical therapy for breast cancer underwent lymphoscintigraphy. The examination was performed after subcutaneous injection of technetium-labeled colloid via the fourth and first interdigital space on the hand of the limb with lymphedema. The level of the technetium label was compared on scintigraphies performed before and after manual lymph drainage. Results were analyzed as a function of the clinical characteristics of the edema. Manual lymphatic drainage produced an effective progression of the label in 25 cases (53.2%), independent of radiotherapy. Contralateral lymph nodes were reached in 5 cases and the homolateral internal mammary nodes in 2. These nodes were visualized only after manual lymphatic drainage. The visualization of the drainage routes in unexpected areas demonstrated the effectiveness of the technique in stimulating accessory routes useful for resorption of lymphedema. The use of two injection sites on the hand is also discussed. This study demonstrated the effect on a single session of manual lymphatic drainage and should be completed with an assessment of a complete series of manual lymphatic drainages.
手法淋巴引流在肢体淋巴水肿的物理治疗中与其他物理技术联合使用。为了评估该方法的有效性，对47例乳腺癌放射外科治疗后出现上肢淋巴水肿的患者进行了淋巴闪烁显像检查。检查是在通过患侧手部第四和第一指间间隙皮下注射锝标记胶体后进行的。在手法淋巴引流前后进行的闪烁显像上比较锝标记的水平。结果根据水肿的临床特征进行分析。手法淋巴引流在25例（53.2%）患者中使标记物有效进展，与放疗无关。5例到达对侧淋巴结，2例到达同侧内乳淋巴结。这些淋巴结仅在手法淋巴引流后显影。在意外区域显示引流途径表明该技术在刺激有助于淋巴水肿吸收的辅助途径方面的有效性。还讨论了在手部使用两个注射部位的情况。本研究证明了单次手法淋巴引流的效果，应通过评估完整系列的手法淋巴引流来完成。
