Qiong Wu, Longxin An, Li Xu, Wen Zhou, Xiaojing Li, Longfei Liu, Qi Tan, Xuecheng Sun, Naibo Feng
{"title":"综合减充血治疗结合针电极刺激有助于术后淋巴水肿的康复。","authors":"Qiong Wu, Longxin An, Li Xu, Wen Zhou, Xiaojing Li, Longfei Liu, Qi Tan, Xuecheng Sun, Naibo Feng","doi":"10.1016/j.jvsv.2025.102337","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the clinical efficacy of complex decongestive therapy (CDT) combined with needle electrode stimulation in the management of lymphedema following lymphaticovenular anastomosis (LVA) and to compare its therapeutic outcomes with conventional CDT alone.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 50 patients with secondary lymphedema who underwent lymphovenous anastomosis (LVA) at the Department of Traumatic Orthopedics, Weifang People's Hospital, between June 2023 and June 2024. All patients met strict inclusion criteria and were randomly assigned to two groups: Group A (complex decongestive therapy [CDT] combined with needle electrode stimulation; n = 25; 3 males, 22 females) and Group B (CDT alone; n = 25; 3 males, 22 females). There was no significant difference in sex distribution between groups (χ<sup>2</sup> = 0.00, p > 0.99), indicating baseline comparability.</p><p><strong>Results: </strong>No significant main effect of group was observed for limb swelling rate (p = 0.46, N = 50), indicating comparable overall swelling levels between groups. A significant main effect of time was found across all time points (preoperatively and at 2 weeks, 1 month, 3 months, 6 months, and 12 months postoperatively; p < 0.01, N = 25), suggesting a general reduction in swelling over time. Importantly, a significant group × time interaction was identified (p = 0.03, N = 25), indicating that the rate of swelling reduction differed, with Group A showing a greater and faster improvement. For quality of life assessed by the Lymphedema Life Impact Scale (LLIS), the between-group difference was not statistically significant (p = 0.09, N = 25). However, a significant time effect was observed (p < 0.01), and a significant group × time interaction (p = 0.02) indicated a more favorable trajectory in Group A. No adverse events, including infection, poor wound healing, or cellulitis, were reported during the study.</p><p><strong>Conclusion: </strong>CDT combined with needle electrode stimulation demonstrates superior efficacy in reducing limb swelling and improving LLIS scores compared to CDT alone in the postoperative management of lymphedema following LVA. This combination therapy significantly enhances postoperative recovery, suggesting its potential as a more effective approach for lymphedema rehabilitation.</p>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. 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All patients met strict inclusion criteria and were randomly assigned to two groups: Group A (complex decongestive therapy [CDT] combined with needle electrode stimulation; n = 25; 3 males, 22 females) and Group B (CDT alone; n = 25; 3 males, 22 females). There was no significant difference in sex distribution between groups (χ<sup>2</sup> = 0.00, p > 0.99), indicating baseline comparability.</p><p><strong>Results: </strong>No significant main effect of group was observed for limb swelling rate (p = 0.46, N = 50), indicating comparable overall swelling levels between groups. A significant main effect of time was found across all time points (preoperatively and at 2 weeks, 1 month, 3 months, 6 months, and 12 months postoperatively; p < 0.01, N = 25), suggesting a general reduction in swelling over time. Importantly, a significant group × time interaction was identified (p = 0.03, N = 25), indicating that the rate of swelling reduction differed, with Group A showing a greater and faster improvement. For quality of life assessed by the Lymphedema Life Impact Scale (LLIS), the between-group difference was not statistically significant (p = 0.09, N = 25). However, a significant time effect was observed (p < 0.01), and a significant group × time interaction (p = 0.02) indicated a more favorable trajectory in Group A. No adverse events, including infection, poor wound healing, or cellulitis, were reported during the study.</p><p><strong>Conclusion: </strong>CDT combined with needle electrode stimulation demonstrates superior efficacy in reducing limb swelling and improving LLIS scores compared to CDT alone in the postoperative management of lymphedema following LVA. This combination therapy significantly enhances postoperative recovery, suggesting its potential as a more effective approach for lymphedema rehabilitation.</p>\",\"PeriodicalId\":17537,\"journal\":{\"name\":\"Journal of vascular surgery. Venous and lymphatic disorders\",\"volume\":\" \",\"pages\":\"102337\"},\"PeriodicalIF\":2.8000,\"publicationDate\":\"2025-10-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of vascular surgery. 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引用次数: 0
摘要
目的:评价综合减充血疗法(CDT)联合针电极刺激治疗淋巴小囊吻合(LVA)后淋巴水肿的临床疗效,并与单纯常规减充血疗法的疗效进行比较。方法:回顾性分析潍坊市人民医院创伤骨科于2023年6月至2024年6月行淋巴静脉吻合术(LVA)的继发性淋巴水肿患者50例。所有患者均符合严格的纳入标准,随机分为两组:A组(CDT联合针电极刺激,n = 25,男3,女22)和B组(CDT单独治疗,n = 25,男3,女22)。各组间性别分布差异无统计学意义(χ2 = 0.00, p < 0.99),具有基线可比性。结果:各组肢体肿胀率无显著主效应(p = 0.46, N = 50),各组整体肿胀水平相当。时间在所有时间点(术前、术后2周、1个月、3个月、6个月和12个月;p < 0.01, N = 25)均有显著的主要影响,表明肿胀随时间的推移普遍减轻。重要的是,发现了显著的组与时间交互作用(p = 0.03, N = 25),表明肿胀减轻的速度不同,a组的改善更大更快。以淋巴水肿生活影响量表(LLIS)评估的生活质量,组间差异无统计学意义(p = 0.09, N = 25)。然而,观察到显著的时间效应(p < 0.01),并且显著的组×时间相互作用(p = 0.02)表明a组的发展轨迹更有利,在研究期间没有报告不良事件,包括感染,伤口愈合不良或蜂窝织炎。结论:CDT联合针电极刺激在减轻肢体肿胀和提高LLIS评分方面优于CDT单独治疗LVA术后淋巴水肿。这种联合治疗显著提高术后恢复,提示其作为淋巴水肿康复的更有效方法的潜力。
Complex decongestive therapy combined with needle electrode stimulation facilitates postoperative rehabilitation of lymphedema.
Objective: To evaluate the clinical efficacy of complex decongestive therapy (CDT) combined with needle electrode stimulation in the management of lymphedema following lymphaticovenular anastomosis (LVA) and to compare its therapeutic outcomes with conventional CDT alone.
Methods: A retrospective analysis was conducted on 50 patients with secondary lymphedema who underwent lymphovenous anastomosis (LVA) at the Department of Traumatic Orthopedics, Weifang People's Hospital, between June 2023 and June 2024. All patients met strict inclusion criteria and were randomly assigned to two groups: Group A (complex decongestive therapy [CDT] combined with needle electrode stimulation; n = 25; 3 males, 22 females) and Group B (CDT alone; n = 25; 3 males, 22 females). There was no significant difference in sex distribution between groups (χ2 = 0.00, p > 0.99), indicating baseline comparability.
Results: No significant main effect of group was observed for limb swelling rate (p = 0.46, N = 50), indicating comparable overall swelling levels between groups. A significant main effect of time was found across all time points (preoperatively and at 2 weeks, 1 month, 3 months, 6 months, and 12 months postoperatively; p < 0.01, N = 25), suggesting a general reduction in swelling over time. Importantly, a significant group × time interaction was identified (p = 0.03, N = 25), indicating that the rate of swelling reduction differed, with Group A showing a greater and faster improvement. For quality of life assessed by the Lymphedema Life Impact Scale (LLIS), the between-group difference was not statistically significant (p = 0.09, N = 25). However, a significant time effect was observed (p < 0.01), and a significant group × time interaction (p = 0.02) indicated a more favorable trajectory in Group A. No adverse events, including infection, poor wound healing, or cellulitis, were reported during the study.
Conclusion: CDT combined with needle electrode stimulation demonstrates superior efficacy in reducing limb swelling and improving LLIS scores compared to CDT alone in the postoperative management of lymphedema following LVA. This combination therapy significantly enhances postoperative recovery, suggesting its potential as a more effective approach for lymphedema rehabilitation.
期刊介绍:
Journal of Vascular Surgery: Venous and Lymphatic Disorders is one of a series of specialist journals launched by the Journal of Vascular Surgery. It aims to be the premier international Journal of medical, endovascular and surgical management of venous and lymphatic disorders. It publishes high quality clinical, research, case reports, techniques, and practice manuscripts related to all aspects of venous and lymphatic disorders, including malformations and wound care, with an emphasis on the practicing clinician. The journal seeks to provide novel and timely information to vascular surgeons, interventionalists, phlebologists, wound care specialists, and allied health professionals who treat patients presenting with vascular and lymphatic disorders. As the official publication of The Society for Vascular Surgery and the American Venous Forum, the Journal will publish, after peer review, selected papers presented at the annual meeting of these organizations and affiliated vascular societies, as well as original articles from members and non-members.