Johansson K, Lie E, Ekdahl C, Lindfeldt J
Department of Physical Therapy, University Hospital, Lund, Sweden.
Lymphology. 1998 Jun;31(2):56-64.
We compared manual lymph drainage (MLD) with sequential pneumatic compression (SPC) for treatment of unilateral arm lymphedema in 28 women previously treated for breast cancer. After 2 weeks of therapy with a standard compression sleeve (Part I) with maintenance of a steady arm volume, each patient was randomly assigned to either one of two treatment regimens (Part II). MLD was performed according to the Vodder technique for 45 min/day and SPC was performed with a pressure of 40-60 mmHg for 2 hours/day. Both treatments were carried out for 2 weeks. Arm volume was measured by water displacement. Arm mobility, strength, and subjective assessments were also determined. Lymphedema was reduced by 49 ml (7% reduction) (p = 0.01) in the total group during Part I. During Part II, the MLD group decreased by 75 ml (15% reduction) (p < 0.001) and the SPC group by 28 ml (7% reduction) (p = 0.03). The total group reported a decrease of tension (p = 0.004) and heaviness (p = 0.01) during Part I. During Part II, only the MLD group reported a further decrease of tension (p = 0.01) and heaviness (p = 0.008). MLD and SPC each significantly decreased arm volume but no significant difference was detected between the two treatment methods.
我们比较了手法淋巴引流（MLD）与序贯气压疗法（SPC）对28名曾接受乳腺癌治疗的女性单侧手臂淋巴水肿的治疗效果。在使用标准加压袖套进行2周治疗（第一部分）并维持手臂体积稳定后，每位患者被随机分配至两种治疗方案之一（第二部分）。MLD按照沃德尔技术每天进行45分钟，SPC以40 - 60毫米汞柱的压力每天进行2小时。两种治疗均持续2周。通过排水法测量手臂体积。还测定了手臂活动度、力量和主观评估。在第一部分中，总体组的淋巴水肿减少了49毫升（减少7%）（p = 0.01）。在第二部分中，MLD组减少了75毫升（减少15%）（p < 0.001），SPC组减少了28毫升（减少7%）（p = 0.03）。总体组在第一部分报告张力（p = 0.004）和沉重感（p = 0.01）有所减轻。在第二部分中，只有MLD组报告张力（p = 0.01）和沉重感（p = 0.008）进一步减轻。MLD和SPC均显著减小了手臂体积，但两种治疗方法之间未检测到显著差异。
