乳腺癌术后淋巴水肿-康复治疗课件

Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,The Second Hospital of Jilin University China,The Second Hospital of Jilin University China,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,The Second Hospital of Jilin University China,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,The Second Hospital of Jilin University China,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,The Second Hospital of Jilin University China,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,The Second Hospital of Jilin University China,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,The Second Hospital of Jilin University China,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,The Second Hospital of Jilin University China,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,The Second Hospital of Jilin University China,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,The Second Hospital of Jilin University China,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,The Second Hospital of Jilin University China,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,The Second Hospital of Jilin University China,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,乳腺癌术后淋巴水肿,康复治疗,1,乳腺癌术后淋巴水肿,淋巴水肿,2,淋巴水肿2,淋巴水肿,3,淋巴水肿3,感觉异常,4,感觉异常4,淋巴水肿,在手术后的淋巴水肿中，以乳腺癌根治术后最为常见。大约,20%,乳腺癌术后的病人发生淋巴水肿。,淋巴闪烁造影和体积测量的结果发现实际发病数更多，可达,40%,，肢体体积增加为,150180ml,。,水肿发生的时间因人而异，手的过度劳累可能是水肿潜伏期中突然发病的诱因。,5,淋巴水肿在手术后的淋巴水肿中，以乳腺癌根治术后最为常见。大约,淋巴水肿,6,急性淋巴水肿,潜伏期,慢性淋巴水肿,淋巴水肿6急性淋巴水肿潜伏期慢性淋巴水肿,7,伤口疤痕形成、淋巴回流受阻，逐渐形成淋巴淤滞,阻塞部位远端淋巴管扩张，淋巴管瓣膜闭合不全,毛细淋巴管内皮细胞连接闭合不全,淋巴肌泵失效,淋巴管增生桥接阻塞部位、恢复淋巴回流,水肿,淋巴管、淋巴结切除,免疫系统,7伤口疤痕形成、淋巴回流受阻，逐渐形成淋巴淤滞阻塞部位远端淋,治疗概要,1.,徒手淋巴引流,（,Manual Lymph Drainage,）,压力,方向,时间,8,治疗概要1.徒手淋巴引流（Manual Lymph Drai,治疗概要,2.,空气泵加压,特殊部位,压力,皮肤情况,禁忌症,9,治疗概要2.空气泵加压9,治疗概要,3.淋巴袖套,10,治疗概要3.淋巴袖套10,治疗概要,4.加压绷带,11,治疗概要4.加压绷带11,治疗概要,5.功能锻炼,12,治疗概要5.功能锻炼12,13,13,14,14,15,15,治疗概要,6.皮肤护理,16,治疗概要6.皮肤护理16,皮肤护理,最好使用酸碱中性的肥皂,含香精、防腐剂、矿物质、凡士林的护肤品避免使用,护肤品可以用沐浴油、肥皂替代品或湿润剂，如乳剂、霜剂和软膏,17,皮肤护理最好使用酸碱中性的肥皂17,皮肤护理,完整无异常的皮肤,干燥皮肤,过度角化皮肤,真菌感染,乳头状瘤,淋巴液渗漏,18,皮肤护理完整无异常的皮肤18,治疗概要,7.,药物干预,8.,外科手术,显微外科手术,病理组织切除手术,19,治疗概要7.药物干预19,注意事项,20,1,避免各种压迫淋巴回流,路径,上的首饰、衣服与配件（戒指、手镯和手表等）,2,不能穿紧身衣服或背带条索勒在患侧上肢,3,患者义乳重量不要太重，内衣松紧度要做适当的调整，不要带钢丝硬件为佳,4,测量血压的气囊会对患肢施加过度的压力，不要在患侧测量血压,注意事项201避免各种压迫淋巴回流路径上的首饰、衣服与配件（,注意事项,1,避免患侧长期负重下垂,2,避免患侧上肢提举重物，尤其造成肢体酸痛或不适的行为都要极力避免,3,避免患侧的日晒、蒸气浴、紫外线以及热敷等，若要想泡温泉时，请不要将患肢进入温泉中，侵泡区域限制在腰部以下为佳，,4,避免常规的推拿或按摩，盲人或普通按摩多属较激烈的深部按摩,5,在旅游和运动方面，尽量避免搭乘飞机、登上高山和剧烈运动，高空低气压或运动重力，是可能造成淋巴水肿或加重的,21,注意事项1避免患侧长期负重下垂2避免患侧上肢提举重物，尤其造,22,22,