全膝关节置换术后淋巴运输受损能否通过人工淋巴引流治疗?

IF 1.9 4区 医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL
Lymphatic research and biology Pub Date : 2025-04-01 Epub Date: 2024-12-26 DOI:10.1089/lrb.2023.0049
Emine Cihan, Necmiye Un Yıldırım, Yeşim Bakar, Onur Bilge
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引用次数: 0

摘要

目的:关节置换术后假体因磨损而释放的颗粒会影响淋巴系统。本研究旨在探讨人工淋巴引流(MLD)技术对全膝关节置换术(TKA)术后淋巴运输早期疼痛、水肿和血乳酸脱氢酶(LDH)水平的影响。方法:随机选取24例行TKA的患者(对照组12例;MLD: 12)。两组患者术后均接受康复治疗。MLD组也在术后3天内接受MLD治疗。分别于术后第3天和第6周进行临床评估。视觉模拟量表(VAS)用于活动期间的疼痛,疼痛阈值测量仪用于疼痛阈值水平,Frustum法用于腿部体积。LDH用实验室测量记录。结果:两组患者VAS活动相关疼痛评分按评估时间比较,差异均有统计学意义(MLD: χ2 = 47.175;P = 0.000;控制;χ2 = 30.995;P < 0.000)。术后第2天(第2天、第3天、第6周)起,MLD组疼痛阈值显著升高;P = 0.015;P = 0.001;P < 0.000)。术后两组患者的腿部体积随时间的推移均显著减小(p < 0.001);然而,两组间(术后第1 - 3天和第6周;P = 0.192;P = 0.343;P = 0.453;P = 0.908)。而MLD组引流后LDH明显降低(术后第1 - 3天;P = 0.002;P = 0.005;P = 0.006),对照组第1天(P = 0.004)和第2天(P = 0.019)随运动增加而增加。结论:运动疗法中加入MLD在降低LDH水平(疼痛和肌肉损伤的标志)方面比单独运动疗法更有效,但对手术引起的水肿无效。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Can Lymphatic Transport Impaired by Total Knee Arthroplasty be Managed with Manual Lymphatic Drainage?

Objective: It is known that particles released from the prosthesis due to wear after joint replacement surgery affect the lymphatic system. This study aimed to investigate the effect of the manual lymphatic drainage (MLD) technique on pain, edema, and blood lactate dehydrogenase (LDH) levels in the early period of lymphatic transport affected by total knee arthroplasty (TKA). Method: Twenty-four patients who underwent TKA were randomly allocated (control: 12; MLD: 12). Both groups received postoperative rehabilitation. The MLD group also received MLD in the first 3 days after surgery. Clinical assessment was undertaken on the third day and at the sixth week postoperatively. The Visual Analog Scale (VAS) was used for pain during activity, algometer measurements for pain threshold levels, and the Frustum method for leg volumes. The LDH was recorded using laboratory measurements. Results: A significant difference was found in the VAS activity-related pain scores of the groups according to the assessment time (MLD: χ2 = 47.175; p = 0.000; control; χ2 = 30.995; p < 0.000). The pain threshold significantly increased in the MLD group from postoperative day 2 (2nd day, 3rd day, 6th week, respectively; p = 0.015; p = 0.001; p < 0.000). Leg volume significantly decreased over time in both groups after surgery (p < 0.001); however, there was no significant difference between the groups (first-third postoperative days and sixth week; p = 0.192; p = 0.343; p = 0.453; p = 0.908, respectively). While the LDH significantly decreased after drainage in the MLD group (first-third postoperative days; p = 0.002; p = 0.005; p = 0.006, respectively), it increased with exercise in the control group, first day (p = 0.004) and second day (p = 0.019). Conclusions: MLD added to exercise therapy is more effective than exercise therapy alone in reducing the LDH level, a marker of pain and muscle damage, but is not effective for edema due to surgery.

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来源期刊
Lymphatic research and biology
Lymphatic research and biology Medicine-Cardiology and Cardiovascular Medicine
CiteScore
3.10
自引率
7.10%
发文量
85
审稿时长
>12 weeks
期刊介绍: Lymphatic Research and Biology delivers the most current peer-reviewed advances and developments in lymphatic biology and pathology from the world’s leading biomedical investigators. The Journal provides original research from a broad range of investigative disciplines, including genetics, biochemistry and biophysics, cellular and molecular biology, physiology and pharmacology, anatomy, developmental biology, and pathology. Lymphatic Research and Biology coverage includes: -Vasculogenesis and angiogenesis -Genetics of lymphatic disorders -Human lymphatic disease, including lymphatic insufficiency and associated vascular anomalies -Physiology of intestinal fluid and protein balance -Immunosurveillance and immune cell trafficking -Tumor biology and metastasis -Pharmacology -Lymphatic imaging -Endothelial and smooth muscle cell biology -Inflammation, infection, and autoimmune disease
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