Investigating the Short-Term Effects of Manual Lymphatic Drainage and Compression Garment Therapies on Lymphatic Function Using Near-Infrared Imaging
Investigating the Short-Term Effects of Manual Lymphatic Drainage and Compression Garment Therapies on Lymphatic Function Using Near-Infrared Imaging
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DOI：
10.1089/lrb.2017.0001
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发表时间：
2017-09-01
影响因子：
1.4
通讯作者：
Fenlon, Deborah
中科院分区：
文献类型：
--
作者：
Lopera, Catalina;Worsley, Peter R.;Fenlon, Deborah
背景：淋巴水肿是一种由淋巴系统功能障碍引起的慢性外周肿胀，可导致不适和上肢运动能力丧失。治疗或控制这种肿胀的方法证据有限，部分原因是缺乏客观的淋巴测量。本研究探讨近红外（NIR）成像在评估干预措施中的作用。方法：9名健康志愿者接受近红外透视，使用微剂量（50 μ L, 0.05% w/v）吲哚菁绿，量化手工淋巴引流15分钟前后的淋巴行为，然后进行10分钟的压缩衣（CG）治疗。每次干预后在前臂和肘部拍照。淋巴功能由淋巴包的数量、大小、位移和速度来定义。分析淋巴参数以评估干预与基础值的效果。结果：淋巴功能的基线（BL）参数显示个体之间在数量、大小和速度上存在很大差异。尽管存在差异，但两种干预措施在前臂的位移和速度上都比BL有统计学意义的改善（p < 0.05）。瞬态淋巴包的速度从BL的中位数6.7 mm/s增加到手动淋巴引流（MLD）后的13.3 mm/s和CG后的10.5 mm/s。结论：MLD后淋巴活性明显升高，短时间CG应用后淋巴活性保持相对升高。近红外透视具有监测淋巴病理的潜力，并为干预措施的评估提供可靠的参数。
Background: Lymphedema is a chronic peripheral swelling caused by a dysfunction of the lymphatic system, leading to discomfort and loss of upper limb movement. Therapies to treat or manage this swelling have limited evidence, partly because of a paucity in objective lymphatic measures. This study explored the role of nearinfrared (NIR) imaging in evaluating interventions. Methods: Nine healthy volunteers underwent NIR fluoroscopy using a microdose (50 mu L, 0.05% w/v) of indocyanine green to quantify lymphatic behavior before and after a 15-minute period of manual lymph drainage followed by compression garment (CG) therapy for a 10-minute period. Images were taken at the forearm and elbow after each intervention. Lymphatic function was defined by the number, size, displacement, and speed of lymph packets. The lymph parameters were analyzed to assess the effects of the interventions compared with basal values. Results: Baseline (BL) parameters of lymph function revealed high variability in the number, size, and speed of packets between individuals. Despite this variance, both interventions showed statistically significant improvement (p < 0.05) in displacement and speed at the forearm compared with BL. The velocity of transient lymph packets increased from a median of 6.7 mm/s at BL to 13.3 mm/s after manual lymphatic drainage (MLD) and 10.5 mm/s after CG. Conclusion: Lymphatic activity increased significantly after MLD, with relative increases being maintained after a short time period of CG application. NIR fluoroscopy has the potential to both monitor lymph pathology and provide robust parameters in the assessment of interventions.