关键词: 改良综合消肿疗法, 下肢淋巴水肿, 情绪

Abstract: Objective To study the therapeutic effect of modified complex decongestion therapy(CDT) on moderate to severe lower limb lymphedema(LLL) after gynecological pelvic tumor surgery. 
Methods A total of 78 patients with moderate to severe LLL after gynecological pelvic tumor surgery were randomly divided into control group(n=39) and modified group(n=39). The control group was treated with traditional CDT, including manual lymphatic drainage(MLD), multi-layer low-elastic bandage, functional exercise and self-skin care, and the modified group was given the same treatment except MLD that was replaced with a negative pressure lymphatic reflux promotion system. Before treatment and at 4 weeks after treatment, the circumference of the affected limb was measured by measuring tape, and the lower limb volume(LLV) was calculated. The lymphedema-related symptom scale was used to evaluate the symptoms of lymphedema, and the extracellular water ratio was measured by the multi-frequency bioelectrical impedance body composition analyzer. Ultrasound imaging was used to detect thickness of full-thickness skin, subcutaneous tissue thickening, deep fascia thickening, subcutaneous tissue echo score, and subcutaneous tissue morphology score, and Hospital Anxiety and Depression Scale (HADS) score was used to evaluate the patient′s emotion. 
Results Compared with those before treatment, at 4 weeks after treatment, patients in the control group and the modified group had reduced limb circumference, LLV and extracellular water ratio, improved lymphedema symptoms, increased skin thickness, thickened subcutaneous tissue and deep fascia, subcutaneous tissue echo score, decreased subcutaneous tissue morphology score, and decreased anxiety score and depression score, suggesting significant difference(P＜0.05). Compared with the control group after treatment, patients in the modified group had reduced limb circumference, LLV, and extracellular water ratio, improved lymphedema symptoms, thickened deep fascia, decreased subcutaneous tissue echo scores, and decreased anxiety scores and depression scores, and the difference was statistically significant(P＜0.05). 
Conclusion The modified CDT can improve moderate to severe LLL, and relieve anxiety and depression, and the therapeutic effect is better than that of traditional CDT and that in the control group. In addition, it is better than modified CDT in the control group with respect to improving the clinical treatment efficiency, which, therefore, is worthy of clinical application.

Key words: modified complex decongestion therapy, lower limb lymphedema, emotion