肢体淋巴水肿微波烘疗对淋巴回流的影响

目的 探讨烘疗对肢体淋巴回流的影响。方法 采用99mTc-Dextran和SPECT对26例肢体淋巴水肿患者进行治疗前后淋巴显像的研究，测量比较淋巴回流速度(LFS)、注射部位的半排时间(T1／2)及淋巴管图像的变化。结果 微波烘疗前，患肢的平均LFS明显低于对侧健肢，分别为7．82cm／min和10．41cm／min；2个疗程治疗后，患肢平均LFS增加到9．36cm／min。而T1／2烘疗前淋巴水肿肢体为154．21min，高于健肢的91．55min，烘疗后显著下降为115．38min。淋巴淤滞图像26例中22例治疗后得到改善，尤以感染性肢体淋巴水肿显著。结论肢体淋巴水肿存在明显的淋巴回流淤滞，微波烘疗能促进淋巴水肿肢体的淋巴回流。

Effects of Microwave Heating on Lymph Flow in the Lymphedema of Extremities

Objective To investigate the changes of lymph flow by microwave heating whichhad achieved an excellent result in the management of lymphedema of extremities. Methods 26 caseswith lymphedema of the extremities had been evaluated by means of lymphoscintigraphy using 99mTc －Dextran and SPECT to examine the lymph flow speed and half－ time(T1/2)clearance of the injection siteas well as lymphatic images of the affected limbs before and after treatment. Results The averagelymph flow speed in the affected limbs was significantly lower than that of the contralateral normal limbswith 7.82cm/min and 10.41cm/min respectively before treatment, and they increased significantly from7.82 to 9.36cm/min after two courses of treatment; in contrary, T1/2 was higher in the lymphedema-tous limbs with an average value of 154.21 min in comparison with 91.55 min contralaterally, and de-creased significantly to 115.38 min after treatment. In addition, lymphatic image disturbances improvedmarkedly in 22/26 cases(84.6% ) after treatment, especially in the patients with infectious lymphede-ma, and showed no changes in two cases. Conclusion The results demonstrated that there was evi-dent lymph flow stasis in lymphedematous limbs, based on the preliminary calculation of lymph flow in-dexes; microwave heating could promote the lymph flow in lymphedema of extremities.