Piller N B, Thelander A
Department of Public Health, School of Medicine, Flinders Medical Centre, Bedford Park, South Australia.
Lymphology. 1998 Jun;31(2):74-86.
Ten women with unilateral arm lymphedema after axillary clearance (radical mastectomy) and radiotherapy for breast cancer received 16 treatment sessions with Low Level Laser Therapy (LLLT) over 10 weeks and seven patients were followed for 36 months. The effect of LLLT was monitored by arm circumference, plethysmography, tonometry, bioimpedance and a questionnaire dealing with subjective symptoms. After treatment, edema volume (both extracellular and intracellular) was decreased, the tissue (except for the upper arm) progressively softened or approached a normal texture, and the patients reported improvement in aches/pains, tightness, heaviness, cramps, pins/needles, and mobility of the arm. Skin integrity was also improved and the index for risk of infection decreased. Follow-up assessment at 1, 3, 6, and 30-36 months showed varying trends although at 30-36 months most subjective parameters and bioimpedance derived data on ECF and ICF tended to return toward pre-treatment levels. Arm circumference continued to show overall improvement, however, with a volume reduction of the affected arm reaching 29%. Tonometry also showed maintenance of near normal values for the involved forearm and anterior and posterior chest; however, the upper arm showed progressive induration. The data suggest that laser treatment, at least initially, improved most objective and subjective parameters of arm lymphedema.
十名因乳腺癌腋窝清扫术（根治性乳房切除术）和放疗后出现单侧手臂淋巴水肿的女性，在10周内接受了16次低强度激光治疗（LLLT），其中七名患者接受了36个月的随访。通过手臂周长、体积描记法、眼压测量法、生物电阻抗以及一份关于主观症状的问卷来监测LLLT的效果。治疗后，水肿体积（细胞外和细胞内）减小，组织（上臂除外）逐渐变软或接近正常质地，患者报告手臂的疼痛/酸痛、紧绷感、沉重感、抽筋、刺痛/麻木以及活动能力有所改善。皮肤完整性也得到改善，感染风险指数降低。在1、3、6和30 - 36个月的随访评估显示出不同的趋势，尽管在30 - 36个月时，大多数主观参数以及从生物电阻抗得出的关于细胞外液和细胞内液的数据倾向于恢复到治疗前水平。然而，手臂周长总体上持续改善，患侧手臂体积减少了29%。眼压测量法也显示受累前臂以及前胸和后背维持在接近正常的值；然而，上臂出现了进行性硬结。数据表明，激光治疗至少在初期改善了手臂淋巴水肿的大多数客观和主观参数。
