림프부종 환자의 보조적 치료로써 히알루론산 분해효소가 가지는 효과

Abstract

Objective: To evaluate the efficacy of hyaluronidase (HA) injection as an adjuvant therapy for complex physical therapy (CPT) in the maintenance phase of secondary lymphedema. Method: A total of 17 patients with upper or lower limb lymphedema were treated with CPT and HA injection. Subjective symptoms were elicited before CPT. HA injection was done at the time of no circumferential change after CPT. All patients performed the circumferential measurements at 5 points every other day. The volume of affected limb was calculated from circumferential measurements. The edematous volumes, which were calculated at the time of 3 day, 7 day after HA injection and discharge were compared with an initial value. Results: The subjects were composed of 17 women with 11 upper and 6 lower limb secondary lymphedema. The average number of injection was 1.8 in the upper limb and 3.2 in the lower limb affected group. After HA injection, the mean volume of affected limb was significantly (p<0.05) decreased compared with the initial value in both groups. In upper and lower limb affected groups, the mean volume at discharge was significantly (p<0.05) decreased compared with initial HA injection. After injection, all patients were presented the improvement of stiffness which may be the symptom of fibrosclerotic change of skin. No patients had significant complications after HA injection except mild flu-like symptom which resolved with conservative management. Conclusion: HA injection is effectively attributed to additional reduction of volume and improvement of subjective symptoms in the maintenance phase of secondary lymphedema patients.