综合消肿治疗联合中药外治法治疗恶性肿瘤术后下肢淋巴水肿的临床疗效及超声显像评估研究

目的研究综合消肿治疗联合中药外治法治疗恶性肿瘤术后下肢淋巴水肿的临床疗效,并对其超声显像进行评估。方法选取2016年7月至2020年7月收治的恶性肿瘤术后下肢淋巴水肿患者共计78例,随机分为治疗组和对照组,每组各39例。对照组采取综合消肿治疗,治疗组在综合消肿治疗基础上,联合中药外治法。两疗程后,比较两组总有效率、患侧肢体周径、肢体组织水分情况、肢体功能障碍改善情况、患者日常生活能力评分、淋巴水肿相关症状,应用超声检测皮肤全层、皮下组织和深筋膜增厚度情况。结果治疗组总有效率为89.7%,对照组总有效率为76.9%。治疗组略高于对照组,但差异无统计学意义(P>0.05)。治疗后,与对照组相比,治疗组患侧肢体周径缩小明显,两组差异有统计学意义(P<0.05)。治疗后两组患者组织水分比率均较治疗前明显改善(P<0.05),治疗后组间差异无统计学意义(P>0.05)。两组患者淋巴水肿相关症状评估较治疗前有明显改善(P<0.05)。组间比较,治疗组的紧绷感、肿胀感、沉重感,以及发热、疼痛改善情况优于对照组(P<0.05)。治疗后,两组组织形态及皮下组织回声均改善,且治疗组的改善情况优于对照组(P<0.05);治疗后,两组皮肤全层增厚度、皮下组织增厚度及深筋膜增厚度均明显下降(P<0.05)。结论应用综合消肿治疗技术联合中药外治法治疗恶性肿瘤术后下肢淋巴水肿,超声显像评估观察指标及临床症状均明显改善,临床疗效可靠。

Clinical efficacy and ultrasonic imaging evaluation of comprehensive decongestion therapy plus external treatment with traditional Chinese medicine in the treatment of lower limb lymphedema following malignant tumor surgery

Objective To study the clinical effect of comprehensive decongestion therapy plus external treatment with traditional Chinese medicine on lower limb lymphedema following malignant tumor surgery,and to evaluate its ultrasonic imaging.Methods From July 2016 to July 2020,78 patients with postoperative lymphedema of lower limb were treated,and they were randomly divided into two groups,with 39 cases in each group.In the control group,patients were treated with comprehensive decongestion therapy,and patients in the treatment group were treated with comprehensive decongestion therapy plus external treatment with traditional Chinese medicine.After two courses of treatment,the total effective rate,the circumference of the affected limb,the water ratio in the limb tissue,the improvement in limb function,scores of daily living ability,and the lymphedema-related symptoms were compared between the two groups.The thickness of whole skin,subcutaneous tissue and deep fascia were detected by ultrasound.Results The total effective rate of the treatment group was 89.7%,and in the control group it was 76.9%.The difference was not statistically significant between treatment and control group(P>0.05).After treatment,the circumference of affected limb in the treatment group was significantly reduced compared with that in the control group,and the difference was statistically significant(P<0.05).After treatment,the water ratio of tissue in the two groups was significantly improved(P<0.05),but the difference was not statistically significant between treatment and control group(P>0.05).The lymphedema-related symptoms in the two groups were significantly improved after treatment(P<0.05).The improvements in tension,swelling,heaviness,fever and pain in the treatment group were better than those in the control group(P<0.05).After treatment,the echo and morphology of subcutaneous tissue in the two groups were significantly improved,and the improvement of the treatment group was better than that of control group(P<0.05).After treatment,the full thickness of skin,the thickness of subcutaneous tissue and deep fascia in the two groups were significantly decreased(P<0.05).Conclusion The comprehensive decongestion therapy plus external treatment with traditional Chinese medicine could improve clinical symptoms and the observation indexes of ultrasound imaging in the treatment of lower limb lymphedema following malignant tumor surgery,with reliable clinical efficacy.