The Influence of microwave and hot water immersion hyperthermia on the lymphedematous skin of lower extremity on 12 patients was studied by using immunohistochemical and lymphoscintigraphic methods. We assumed that the subsidence of inflammatory changes in the lymphedematous limb and/or local absorption of tissue fluid protein following local microwave heating, but not the augmented lymph How seemed to be responsible for the reduction of edema.
Thirteen cases of unilateral lymphedema of lower extremity were treated by the anastomosis between the suporficial and deep lymphaties. The rate of subeidence of edema at 2 weeks and 6 months after operation were 57.1±18.5%and 47.3± 22.9%, respectively, It was believed that this type of oporation had the advantageS of anastomosis on the tissues of same origin, unlikely occurrence of thrombosis at the anastomotic stoma, small incision, less surgical trauma and acceptable by patients.
OBJECTIVE To observe the character of local and systemic immune responses in chronic limb lymphedema, and to investigate the effect of microwave on immunological response. METHODS From November 1996 to February 1998, 27 patients with chronic limb lymphedema were adopted in this study. Among them, there were 11 males and 16 females, the average age was 36.6 years. These patients were classified as the experimental group and 10 healthy volunteers as the control group. Before and after microwave heating and bandaging treatment, T and B lymphocyte in peripheral blood and skin infiltrating cells in the patients and volunteers were detected and phenotyped with alkaline phosphatase-anti-alkaline phosphatase(APAAP) and avidin biotin peroxidase complex (ABC) immunohistochemical methods respectively. RESULTS There were decreases of CD4+ T lymphocyte and the ratio of CD4+/CD8+ in peripheral blood and predominant dermal perivascular T lymphocyte infiltration in chronic limb lymphedema patients. After two courses of microwave heating and bandaging treatment, it was found that the number of CD4+ T lymphocytes increased and the ratio of CD4+/CD8+ was restored to normal levels, and dermal perivascular T lymphocyte infiltration decreased greatly. CONCLUSION Microwave heating and bandaging treatment can modulate the systemic and local immunological imbalance of chronic limb lymphedema.
Abstract Sixty-four cases of upper limb lymphedema following radical operation of carcinoma of breast were treated by microwave therapy. The course of treatment was divided into two stages. Each stage was one hour a day for 20 days. Elastic band was put on the limb betweenevery therapy except the time of sleeping at night. After 1 months to 2 years follow-up, the results showed: symptoms disappeared obviously; the edema had gone down (Plt;0.01). The relapse frequency of erysipelas-like syndrome decreased obviously (Plt;0.01). The skin elasticity restored, and no complication appeared. It was concluded that microwave therapy was an effective conservative treatment in treating upper limb lymphedema following radical operaion of carcinoma of breast.
Objective To explore the preventive effectiveness of early physiotherapy on arm lymphedema after modified radical mastectomy for breast cancer. Methods A total of 206 patients who underwent modified radical mastectomy for breast cancer in The First Affiliated Hospital of Henan University from June 2014 to June 2016, enrolled in this randomized controlled clinical trial. Then these patients were randomly divided into intervention group and control group equally. Patients in the control group received routine treatment, and the patients in the intervention group began to use the air pressure pump combined with the microwave physiotherapy on the second day after the radical surgery. The incidences of limb lymphedema in 6 months and 1 year after operation between the 2 groups were compared, and the influencing factors of arm lymphedema were explored. Results The clinical data of 195 patients were analyzed at end, including 99 patients of the intervention group and 96 patients of the control group. ① There were statistical significance in the incidences of arm lymphedema in 6 months and 1 year after operation between the 2 groups (P<0.05), that incidences of arm lymphedema in the intervention group were both lower than those of the control group at the2 time points [6 months after operation: 2.0% (2/99)vs. 9.4% (9/96); 1 year after operation: 5.1% (5/99) vs. 17.7% (17/96)]. ② The results of non-conditional logistic regression analysis shown that, age (OR=1.45, P=0.008), tumor location (OR=1.72, P<0.001), TNM stage (OR=2.01, P=0.033), the number of invasive axillary lymph nodes (OR=1.15, P=0.005), and postoperative radiotherapy (OR=1.23, P=0.016) were the influencing factors of arm lymphedema after modified radical mastectomy for breast cancer, patients with age older than 60 years, tumor position at the outside area, stage Ⅲ of TNM, the number of invasive axillary lymph nodes >5, and patients received radiotherapy after operation had high risk of arm lymphedema. Conclusion Early physiotherapy can effectively prevent the occurrence of arm lymphedema after modified radical mastectomy for breast cancer, and early physiotherapy should be performed for patients with high risk of arm lymphedema.
20 cases of chronic lymphedema of theleg were examined by lymphoscintigraphybefore and after Heating and Bandage Treat-ment. The result showed that lymph flowwere improved in 17 cases, edematous legsafter the treatment, among these, lymphflow were much improved in 4 patients, al-most reaching a normal state. The compari-son of clarity and appearing time of imagesand the comparison of lymph flow rate be-fore and after the treatment also showed sta-tistical significance. It is further proved from this study that Heating and Bandage Treatment can improve lymphatic circulation in lymphedematous limbs.
目的探讨肢体淋巴水肿疾病中相关恶性肿瘤的诊断与治疗。方法对我院 1988年10月至2000年12月收治的332例肢体淋巴水肿患者，根据临床表现，用B超、淋巴管造影、静脉造影或CT等手段作为病因诊断检查，对可疑恶性肿瘤病例用穿刺、局部切除或局部探查的方法共活检20例。结果检出由恶性肿瘤引发的淋巴水肿18例,其中原发淋巴系统恶性肿瘤4例，均为下肢； 继发性淋巴结转移癌14例，上、下肢各7例，并予相应治疗。结论重视本病临床表现，可使患者获得及早诊断，及时治疗。
Objective To study a new method of treatment for upper limb lymphedema after radical mastectomy. Methods From Jun. 2001 to Sep. 2003, 11 cases(2with complication of erysipelas ) of upper limb lymphedema being treated with radical mastectomy for more than 2 years were used as model. All the edema of limbs was sucked from hypodermis with liposuction technique and compressed with compression garment. Three months after operation, elasticity stress was conducted every night. Results The reduction of the edema of upper limbswas remarkable. The average decrease of circumference was 4 cm. No erysipelas was observed. Conclusion The liposuction technique and elasticity stress is a new and effective approach to the treatment of upper limb lymphedema.