手法淋巴引流治疗乳腺癌术后上肢淋巴水肿

目的 探讨运用手法淋巴引流(Manual Lymph Drainage,MLD)治疗乳腺癌术后上肢淋巴水肿的疗效。方法2008年至2012年,101例乳腺癌术后上肢淋巴水肿患者按治疗前患肢与健肢的周径(d)差值分3组:A组(d5 cm)。3组患者均进行1个疗程(15 d)的淋巴水肿综合消肿治疗(Complex Decongestive Therapy,CDT):手法淋巴引流+低弹性绷带包扎。通过检测引流前后健患侧的组织水分和肢体周径,计算水分比率与周径比率,同时调查患者对手法引流及绷带使用情况的主观感受,以观察并评价患者对治疗的适应性和接受度。组织水分采用多频生物电阻人体成分分析仪进行检测。结果 101例患者经CDT治疗后,患肢组织水分和肢体周径均呈显著下降(PB组>A组(P<0.01),即治疗效果与水肿严重程度成正比。几乎所有患者对治疗方法及效果表示满意。结论 CDT能有效促进乳腺癌术后上肢淋巴水肿的淋巴回流,减轻患肢水肿,改善患肢外形,帮助功能恢复,并且该治疗对水肿程度较重的患者疗效尤其显著。     

乳腺癌术后手背部Ⅲ级淋巴水肿行多层绷带联合施耐德包扎效果探讨

目的 促进乳腺癌术后患侧手背部Ⅲ级淋巴水肿患者淋巴回流,减轻局部症状与病理改变。 方法 将来我院淋巴水肿门诊就诊的86例乳腺癌术后患侧上肢Ⅲ级淋巴水肿患者按就诊时间段分为常规组44例、改进组42例。常规组行常规多层绷带从指端到肩下加压包扎;改进组采用多层绷带联合施耐德包扎法。每天1次,连续20次后评价效果。 结果 改进组患侧手掌周径减小程度显著优于常规组（均P＜0.01）,紧绷感、麻木感、肿胀感发生率显著低于常规组（P＜0.05, P＜0.01）。 结论 多层绷带联合施耐德包扎法可有效促进淋巴回流,有利于恢复肢体形状,缓解主观症状。     

肢体慢性淋巴水肿CDT治疗后低弹力绷带使用时长对远期疗效的影响

目的探讨肢体慢性淋巴水肿CDT(Complex decongestion therapy)治疗后低弹绷带使用时长对于长期疗效的影响。方法2016至今,对57例淋巴水肿患者按治疗结束后自我使用低弹绷带包扎时长(t)分为A(>1年)、B(0.5~1年)、C(<0.5年)3组。采用多频生物电阻人体成分分析仪测量组织水分,卷尺测量肢体周径。比较3组患者复诊时与治疗结束时水分和周径的变化。结果A组在维持肢体周径、水分方面明显优于B组和C组,B组则优于C组(P<0.05)。3组治疗后的丹毒发作频率均有改善,A组改善最为明显(P<0.05)。结论肢体慢性淋巴水肿患者在CDT治疗结束后应继续使用低弹绷带包扎患肢,坚持使用越久的患者长期疗效越好。     

宫颈癌治疗后继发性双下肢淋巴水肿患者的护理

对19例宫颈癌治疗后继发性双下肢淋巴水肿患者行手法引流综合消肿治疗,包括手法淋巴引流、弹性绷带包扎、功能锻炼等,治疗1个疗程,患者下肢周径较治疗前明显减小、水肿程度减轻,皮肤肿胀感与肢体沉重感均减轻,皮肤纤维化程度明显降低,临床症状显著改善,住院16～23 d出院。提出加强双下肢水肿的评估、皮肤护理、手法淋巴引流的护理、绷带包扎护理、功能锻炼指导、心理护理及延续护理,可提高双下肢淋巴水肿患者治疗效果。     

手法淋巴引流综合消肿疗法治疗盆腔恶性肿瘤根治术后下肢淋巴水肿

目的 探讨手法淋巴引流综合消肿疗法(Complex Decongestion Therapy,CDT)治疗盆腔肿瘤根治术后下肢淋巴水肿的疗效。方法 自2011年起,收治76例盆腔肿瘤根治术后的单侧下肢淋巴水肿患者,其中子宫颈癌、子宫内膜癌和卵巢癌根治术后的女性患者70例,直肠、前列腺癌手术后的男性6例。按照健患侧下肢周径的差异,将患者分为3组:轻度组30例,中度组24例,重度组22例。患者均进行1个疗程(20天d)的CDT治疗,采用多频生物电阻人体成分分析仪和肢体周径测量观察治疗效果。结果 治疗后所有患肢的水肿明显减轻,组织内水分比率显著减少(P<0.01),周径比率显著缩小(P<0.01)。3组中,中度组和重度组的水分下降更为显著,重度组的周径缩小最为显著。结论 手法淋巴引流综合消肿治疗是治疗盆腔肿瘤根治手术后下肢淋巴水肿有效、安全的治疗手段。手法淋巴引流综合治疗适用于各期手术后下肢继发性淋巴水肿,包括重度淋巴水肿。     

弹力绷带加压包扎结合切口闭式引流在腹股沟区淋巴瘘治疗中的应用

目的探讨改良的局部加压包扎法治疗腹股沟区切口淋巴瘘的疗效。方法 2005年12月至2010年11月期间对10例腹股沟区切口淋巴瘘患者采用弹力绷带持续加压包扎,同时切口放置闭式引流装置进行治疗。结果全部患者切口经加压包扎后淋巴液均明显减少,经持续加压包扎3~20 d(平均7.2 d)后获临床治愈;其中1例患者于加压包扎后第4天出现下肢股浅静脉血栓,经及时溶栓和抗凝治疗后好转。本组患者随访1~59个月(平均14.7个月),10例患者切口均一期愈合,无下肢淋巴水肿发生。结论弹力绷带加压包扎结合切口闭式引流治疗腹股沟区切口淋巴瘘疗效显著,该方法简单、安全,值得临床推广应用。     

远红外线治疗妇科癌症术后下肢淋巴水肿的安全性研究

目的 探讨远红外线治疗妇科癌症术后淋巴水肿患者的有效性和安全性.方法 2013年1月至2020年1月,选取74名妇科癌症术后淋巴水肿的患者,分别接受绷带治疗(n=35)和远红外线+绷带治疗(n=39).1年后评估患者淋巴水肿肢体积液量、淋巴水肿肢体周径、血清肿瘤标志物CA125;记录阴道、腹股沟-盆腔淋巴结变化情况,以...     

空气波压力治疗乳腺癌术后患者上肢淋巴水肿效果观察

目的探讨应用空气波压力治疗乳腺癌术后患者上肢淋巴水肿的治疗效果。方法对22例上肢淋巴水肿患者采用空气波压力治疗2个疗程。结果治疗后患者普遍反映肢体轻松，活动灵便，皮肤张力下降。治疗前后患肢4个测试点周径比较，差异有显著性意义（均P〈0．05）。结论空气波压力治疗乳腺癌术后上肢淋巴水肿，效果较好，操作简便，使用安全、无痛苦。     

手法淋巴引流综合治疗肢体慢性淋巴水肿

目的 探讨采用手法淋巴引流治疗慢性淋巴水肿的新方法.方法 50例慢性肢体淋巴水肿患者接受了手法淋巴引流综合消肿治疗,对体表(包括躯干和肢体)淋巴系统沿淋巴回流方向和途径做轻柔的按压和按摩.50例中原发性淋巴水肿29例,继发性21例;下肢患病42例,上肢患病8例.采用多频生物电阻人体成分分析仪检测组织水肿和测量肢体周径检验治疗效果.结果 经过1～2个疗程的治疗,50例患病肢体的水肿均有不同程度的减轻,表现为患肢组织水肿程度显著减轻(P＜0.05)和患肢周径的显著缩小(P＜0.05).肢体周径与组织水肿变化的相关性检验表明两者有非常显著的相关性(rs=0.774,P＜0.01).结论 手法淋巴引流综合治疗的有效地促进滞留组织淋巴水肿的回流,减轻肢体的肿胀,改善患肢的外形,是治疗慢性淋巴水肿有效的治疗手段.     

烘绑疗法治疗肢体慢性淋巴水肿

目的：观察烘绑疗法治疗肢体慢性淋巴水肿的临床疗效。方法自2012年1月至2013年9月,53例肢体慢性淋巴水肿患者接受烘绑疗法治疗,治疗前后采用多频生物电阻人体成分分析仪检测组织水肿程度,卷尺测量患肢周径变化。结果烘绑治疗后,患肢组织水肿程度明显减轻（P=0.006）,患肢周径明显缩小（P=0.000）。长期随访显示,患者主观感觉改善明显,后续弹性材料加压治疗减少了水肿复发。烘绑治疗前后水分与周径变化具有明显相关性（r=0.356, P=0.01）。结论烘绑疗法可有效消除慢性淋巴水肿患者的肢体水肿,后续弹性材料加压治疗亦不可缺少。     

"Free" and "exchangeable" or "trapped" and "non-exchangeable" water in cartilage

We repeated some of our own previous experiments, as well as some of Torzilli's recent experiments (11) on which he bases his conclusions relating to a nonexchangeable "trapped water" in cartilage. We are unable to confirm Torzilli's findings. We observed partition coefficients for 3H.HO very close to unity. That both the extrafibrillar and most of the intrafibrillar water is freely exchangeable and behaves as available water towards small solutes has been independently shown (3) for other collagenous tissues. All the different permutations of partition experiments have yielded results that are fully consistent with our original picture of the very major fraction of cartilage water being free.     

Effect of electrolyzed water on wound healing

Electrolyzed water accelerated the healing of full-thickness cutaneous wounds in rats, but only anode chamber water (acid pH or neutralized) was effective. Hypochlorous acid (HOCl), also produced by electrolysis, was ineffective, suggesting that these types of electrolyzed water enhance wound healing by a mechanism unrelated to the well-known antibacterial action of HOCl. One possibility is that reactive oxygen species, shown to be electron spin resonance spectra present in anode chamber water, might trigger early wound healing through fibroblast migration and proliferation.     

Electrolyte-free water clearance: a key to the diagnosis of hypernatremia in resolving acute renal failure

Hypernatremia usually results from the loss of water from the body in excess of loss of electrolytes. Although urinary loss of free water is usually thought of when the urine is dilute, it can also occur when the urine is relatively concentrated, for example after administration of osmotic diuretics. We present a case of hypernatremia in the setting of resolving acute renal failure. Quantitative analysis of urinary losses and the concept of electrolyte-free water clearance help to explain the development and persistence of hypernatremia in this case. Urine in such cases is typically rich in urea (an irrelevant osmole from the perspective of plasma sodium) with low concentrations of sodium and potassium (osmoles that determine plasma sodium concentration). So from the perspective of plasma sodium-determining osmoles (sodium and potassium) this hyperosmolar urine is actually “dilute”, resulting in loss of free water and a rise in the plasma sodium concentration. This case illustrates the utility of the electrolyte-free water concept in understanding the development of hypernatremia in resolving acute renal failure. We discuss the evolution of these concepts and how they can be applied to typical clinical situations.     

Whole-body electrolyte-free water clearance: derivation and clinical utility in analyzing the pathogenesis of the dysnatremias

The total exchangeable sodium (Na_e), total exchangeable potassium (K_e), and total body water (TBW) are the major determinants of the plasma water sodium concentration ([Na⁺]_pw). The relationship between [Na⁺]_pw and Na_e, K_e, and TBW was empirically determined by Edelman et al., where: [Na⁺]_pw = 1.11(Na_e + K_e)/TBW − 25.6 (Eq. 1). According to Eq. 1, changes in the mass balance of Na⁺, K⁺, and H₂O will therefore result in changes in the [Na⁺]_pw. Historically, in evaluating the pathogenesis of the dysnatremias, free water clearance (FWC) and electrolyte-free water clearance (EFWC) have been used to evaluate the pathophysiology of the dysnatremias. However, such analyses are only valid when there is no concomitant input and non-renal output of Na⁺, K⁺, and H₂O. Since the classic FWC and EFWC formulas fail to account for the input and non-renal output of Na⁺, K⁺, and H₂O, these formulas cannot be used to evaluate the pathogenesis of the dysnatremias or to predict the directional change in the [Na⁺]_pw. In this article, we have addressed this limitation by deriving a new formula, termed whole-body electrolyte-free water clearance (WB-EFWC), which calculates whole-body electrolyte-free water clearance for a given mass balance of Na⁺, K⁺, and H₂O, rather than simply the urinary component (FWC, EFWC formulas). Unlike previous formulas, which consider only the renal component of electrolyte-free water clearance, WB-EFWC accounts for all sources of input and output of Na⁺, K⁺, and H₂O, and will therefore be helpful in conceptually understanding the basis for changes in the [Na⁺]_pw in patients with the dysnatremias.     

Measurement of extravascular lung water — methods and clinical implications

The estimation of changes in extravascular lung water during different experimental and clinical conditions forms an intriguing field of research. Present methods for the measurement of lung water are difficult to apply in day-to-day clinical practice. Most methods are not only low in accuracy and sensitivity but are also invasive. A new indicator-dilution technique using heavy water and idiocyanine green as diffusible and nondiffusible indicators, respectively, may provide us with a new investigative method for longterm bedside estimation of lung water.     

Aquaporin water channels in mammals

Ten aquaporins have been cloned from various mammalian tissues. They are grouped according to their structure and function. The first group consists of 7 aquaporins; AQP0, 1, 2, 4, 5, 6, and 8. These channel molecules selectively transport water and do not transport glycerol and urea. The second group consists of 3 aquaporins; AQP3, 7, and 9. They transport not only water, but also small nonionic molecules such as glycerol and urea. The extensive tissue distribution and physiologic regulation by dehydration and hormones of these aquaporins suggest that aquaporins have important functions in water and solute transport in the body. However, the recent studies of knockout animals and humans with defective mutations of aquaporins showed unexpectedly small phenotypic effects. It is possible that other, unidentified aquaporins may compensate for these deficiencies. The future challenge of research in aquaporins should be the identification of their physiologic significance, and the discovery of new members, which will expand the research area of water metabolism and deepen our understanding of the physiology and pathophysiology of water transport in our body.     

酒精蒸馏废水回用模式与回用极限的探讨

对酒精蒸馏废水的回用模式和回用极限进行了探讨和数学推导，发现在配料水全部用废水的情况下，回用极限基本上与回用方法无关，回用方法不同只影响是否废水能全部回用。结果认为ＳＣＰ培养二次废水回用法及其改良法为解决酒精蒸馏废水问题的最佳模式。