How to disperse the lymph throughout the body: the main methods of treatment for lymph stagnation. Why does lymphedema occur? Treatment for heavy legs

After a hard labor day almost every fifth inhabitant of the planet observes a slight swelling of the legs. Most often, the situation returns to normal by morning, otherwise the symptoms may indicate the presence of lymphostasis of the legs.

In medicine, this disease is characterized by an increase in tissue edema, the cause of which is a violation of the outflow of fluid through the vessels. lymphatic system.

Lymphostasis (lymphedema) can be acquired or congenital.

At risk are people whose profession requires a lot of walking or standing, they include: sellers, doctors, teachers and athletes who have a high risk of injury.

Symptoms and types of disease

Lymphedema has three stages, which differ in symptoms:

1. First stage has small swellings that appear at the end of the day and disappear on their own after a few hours of rest or in the morning. Puffiness can be the consequences of severe physical activity, prolonged immobility and a large amount of fluid drunk during the day.

The bases of the fingers and ankle joint the most common sites of localization of swelling. In these places skin covering a little pale and when pressed forms a small fold, without bringing pain.

2. Second stage differs in painful sensations, preservation of puffiness even after rest and growth connective tissue. The disease can last up to several years. Over time, swelling rises up the leg and thickens when pressed. long time fingerprint remains.

The skin becomes cyanotic, ulcers, wounds, warty outgrowths may appear. The skin of the legs is constantly stretched and begins to crack, which provokes the process of inflammation and the incessant flow of lymph. With prolonged walking or immobility of the legs, cramps of the calf muscles may appear.

3. Third stage characterized by irreversible outflow of lymph and the appearance of fibrocystic changes, causing the appearance Ivory. Symptoms are manifested in the form of eczema, trophic ulcers, erysipelas.

Lack of treatment leads to sepsis and lethal outcome. The affected limb loses the shape of the leg, the skin turns blue, and the mobile functions of the leg are completely lost.

Regardless of the stage, the disease has common symptoms:

  • the presence of weakness throughout the day;
  • frequent headache;
  • white coating can be found on the tongue;
  • low concentration of attention;
  • joint pain;
  • overweight.

Diagnostics

If symptoms of the disease appear, it is necessary to contact a vascular surgeon, who, after collecting a detailed history, gives directions for additional examinations:

When diagnosing lymphatic edema, it is necessary to undergo a pelvic ultrasound to find tumors or inflammatory process that interfere with lymphatic drainage.

Change biochemical analysis blood determines the presence of proteins in the blood and liver enzymes, which may indicate the beginning of the inflammatory process. To exclude kidney pathologies, it is necessary to pass general analysis blood.

Before Appointment drug treatment it is necessary to take into account all the features of the body, so the passage ultrasound hearts are a must.

Treatment

Treatment is primarily aimed at restoring normal lymphatic flow. For example, to restore microcirculation in tissues, preparations of the phlebotonic group (Vazoket, Detralex) are prescribed. On the initial stage to improve venous tone, Troxevasin or Paroven is prescribed.

A special role in the treatment is given to anti-inflammatory and decongestant drugs (Reopyrin and Butadion). To strengthen the walls of blood vessels, vitamins, succinic acid are prescribed.

Apart from medicines treatment includes:

  • laser therapy;
  • magnetotherapy;
  • electrical stimulation of contractility lymphatic vessels;
  • reinfusion of blood after ultraviolet irradiation.

Traditional treatment can be supplemented with means traditional medicine but only after consultation with your doctor.

Herbal treatment may include decoctions, infusions, compresses and body wraps.

Elephant legs - what is it? How to treat and what to do, doctors - specialists tell, watch the video:

Diet and regimen for lymphostasis of the legs

In addition to drug treatment, the attending physician gives the patient recommendations, the implementation of which contributes to a quick recovery:

Particular attention in lymphatic edema is given to the nutrition of the patient. First of all, you need to give up salty and spicy food that cause intense thirst and fluid retention in the lymph.

During the day it is necessary to drink no more than two liters of liquid. It is recommended to replace tea and coffee with compote without sugar, fruit drink or herbal tea. The patient needs to reduce the consumption of carbonated drinks, bread, sweets and confectionery.

AT daily diet need to add a large number of fresh vegetables and fruits that need to be consumed boiled, stewed. Reduce the amount of vegetable and animal fats to a minimum.

But vegetable proteins use in large quantities, they are contained in buckwheat, legumes and nuts.

Lymphostasis requires immediate treatment. Therefore, at the first signs of the disease, it is not worth postponing a visit to specialists. In a timely manner Taken measures give a better chance of recovery.

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Modern lymphatic correction technologies

Treatment lymph edema(lymphedema)

Every tenth person in the world suffers from edema of the extremities. The causes of edema are different. One of the reasons is lymphatic edema, which is not amenable to conventional methods of treatment. There is no single method for their treatment. In our country, the problem is exacerbated by the lack of specialized centers to provide qualified assistance. Patients often simply stop applying for medical care due to its inefficiency. The Clinic of the Institute of Lymphology is the only medical institution beyond the Urals that deals with the diagnosis and treatment of lymphatic edema.

The head Vadim Valeryevich Nimaev tells about the specifics of this disease and methods of its treatment:

How does lymphedema appear?

It is known that in the body, blood flows through the arteries, returning through the veins to the heart. At the same time, the so-called "littered" liquid remains between the cells, which is discharged from the tissues through the vessels of the lymphatic system. Accordingly, if there are interruptions in the work of the lymphatic system, then this excess fluid begins to accumulate in the tissues, which is manifested by edema, an increase in the volume of the affected part of the body.

Common cause of edema lower extremities may be the so-called primary lymphedema; due to congenital problems caused by underdevelopment of the lymphatic vessels. On the hands, edema is most often formed due to combined treatment breast tumors when removed The lymph nodes and/or irradiation was performed. Very rarely, lymphedema can be accompanied by damage to several regions (face, hands, external genitalia). A factor that may be the cause of clinical significant edema, if present, the cause of lymphedema progression is erysipelas. An increase in edema is often associated with recurring erysipelas.

Regardless of the cause of lymphedema, fluid with large proteins accumulates in the tissues, which leads not only to an increase in volume, but also to a pronounced thickening of the skin and subcutaneous tissue tissues, and such edema can progress rapidly. Lymphedema can occur as a result of trauma, inflammation or tumors.

There are four stages of lymphatic edema, from the appearance of an incoming symptom to the development of elephantiasis.

Lymphedema, as a result of a violation of the outflow of lymph through the lymphatic vessels, is accompanied by thickening of the limb, thickening of the skin, and with the progression of the disease - ulcers, the development of elephantiasis. There are primary and secondary lymphedema.

Causes of lymphedema:

Congenital underdevelopment of lymph nodes and lymphatic vessels;

Inflammatory processes;

Traumatic injuries;

malignant tumors;

Lymphedema resulting from venous disease (post-thrombotic disease, varicose disease), which is called phlebolymphedema.

When diagnosing lymphedema of the lower extremities, first of all, other causes of edema should be excluded:

Cardiac edema

Edema associated with kidney disease;

Edema associated with taking medications;

Edema associated with insufficient thyroid function;

In order to clarify the nature of the course of the disease, the state of the drainage function, the cause of edema, in some cases it is necessary to use special research methods, for example:

Lymphoscintigraphy;

Dopplerography;

CT and MR-tomography;

Lymphangiography.

What threatens running edema?

Women are most susceptible to lymphedema. Of course, they perceive this as a terrible lack of appearance, problems with the choice of clothes and shoes are added, and as the disease progresses, physical discomfort begins to appear. Cases are described when extremely neglected edema led to malignant degeneration of tissues.

Techniques for the treatment of lymphatic edema

Currently, the main method of treating lymphatic edema is complex anti-edematous therapy, including skin care, manual lymphatic drainage, gymnastics and bandaging.

In addition, the clinic of the Research Institute of Lymphology uses a number of unique devices and techniques for physiotherapy. For example, a device for stimulating the lymphatic vessels, with which you can improve the functions of the lymphatic system, and it begins to contract more actively and pump lymph. The low-frequency ultrasound device acts on the subcutaneous tissue and serves as a conductor for drugs. Large protein molecules that accumulate in tissues can be broken down using special enzymes under the influence of low-frequency ultrasound. On the late stages edema, if it does not give in conservative treatment, you can physically reduce the mass of the limb. This is a surgical procedure in which excess fluid and tissue is removed through small punctures using aspiration similar to liposuction.

Swelling of tissues, especially subcutaneous tissue, due to stagnation of lymph caused by congenital defect or acquired damage to the lymphatic vessels. leads to the onset of a chronic inflammatory process varying degrees severity with concomitant hypertrophy of the skin and subcutaneous tissue.

Clinical picture: lymphedema due to lymphadenectomy or infection usually develops after a latent period of several months or even years. Doughy and malleable at first, it tends to become harder over time. In patients with proximal damage to the lymphatic system (for example, after lymphadenectomy), edema, especially on early stage, may only affect the proximal limb and adjacent quadrant of the trunk (shoulder and/or mammary gland, thigh and/or external genitalia).

Symptoms of Lymphedema

Symptoms characteristic of lymphedema of the lower extremities: the skin of the forefoot and the base of the second toe becomes hard, which makes it impossible to form a skin fold, swelling of the toes (in the form of sausages). With the increase in edema, the tendency to relapse increases. bacterial infections skin and subcutaneous tissue (dermatolymphangitis). Gradually, significant deformity of the affected limb (elephantiasis) may develop.

Diagnostics: in most cases - based on clinical picture. If necessary, lymphoscintigraphy is prescribed. An MRI or CT scan may be helpful in differential diagnosis. When conducting differential diagnosis consider: swelling of the subcutaneous fat (only in women, "columnar legs" - a symmetrical accumulation of adipose tissue on the legs, with the exception of the feet), swelling with venous insufficiency, positional edema (due to a long stay in a sitting or standing position in persons without venous insufficiency, myxomatous edema in hypothyroidism, pretibial myxedema in Graves-Basedow disease, cyclic idiopathic edema, edema in severe, with hypoalbuminemia, inflammatory.

Treatment of lymphedema

The main method is complex treatment, including lymphatic drainage techniques, compression bandages and drainage exercises. Pneumatic compression may be used during treatment. In cases resistant to compression treatment, nice results gives liposuction. Contraindications: acute inflammation skin and subcutaneous tissue, fresh deep vein thrombosis of the lower extremities, decompensated congestive heart failure. After completing the initial intensive treatment patients should wear during the day compression stockings or sleeves corresponding to the degree of compression; sometimes it is necessary to apply bandages on the limb at night. Complicated skin and subcutaneous tissue infections should be treated empirically with antibiotics (eg, β-lactamase-resistant penicillin with a β-lactamase inhibitor), usually for 10 to 14 days, until symptoms resolve. To prevent recurrence of the infection, in addition to careful skin care and care of injuries, it may be necessary prophylactic use an antibiotic, eg, benzathine benzylpenicillin (1.2 million units, IM) every 2-3 weeks. for 1 year or longer.

*The information on the site is for informational purposes only. All materials and prices posted on the site are not public offer determined by the provisions of Art. 437 of the Civil Code of the Russian Federation. For exact information, please contact the clinic staff or visit our clinic. List of rendered paid services listed in the price list of the Yusupov hospital.

*The information on the site is for informational purposes only. All materials and prices posted on the site are not a public offer, determined by the provisions of Art. 437 of the Civil Code of the Russian Federation. For exact information, please contact the clinic staff or visit our clinic.

In the human body, blood flows through the arteries and returns to the heart through the veins. Fluid remains between the cells, which is removed from the tissues through the vessels of the lymphatic system. If there are interruptions in the work of the lymphatic system, then this excess fluid begins to accumulate in the tissues, which is manifested by edema and an increase in the volume of the affected part of the body.

Lymph edema is easy to diagnose, difficulties arise in identifying the cause of the violation of the outflow of lymphatic fluid. Doctors of the Yusupov hospital carry out diagnostics using modern equipment. Therapy in each case is selected individually.

Causes of lymphedema

A common cause of lymphedema in the lower extremities may be primary lymphedema. The disease is caused by congenital underdevelopment of the lymphatic vessels. On the upper limbs edema is most often formed as a result of the combined treatment of breast tumors, when lymph nodes are removed from patients or irradiation was performed. Very rarely, lymphedema can be localized in several areas: on the face, hands, external genitalia. Lymphatic edema is often formed after several times of erysipelas.

Regardless of the cause of lymphedema, fluid containing large protein molecules accumulates in the tissues. This leads not only to an increase in the volume of the limb, but also to a pronounced thickening of the skin, subcutaneous tissue tissues. This swelling can progress quickly. Lymphatic edema can occur as a result of trauma, tumors or inflammatory processes.

Diagnosis of lymphatic edema

There are 4 stages of lymphatic edema, they can be in the form of slight swelling and, if the disease is started, the development of elephantiasis. At the most mild stage lymphostasis, patients note the systematic appearance of transient edema of the limb, which is noticeable in the evening and disappears on its own in the morning, after rest. Lymphatic edema tends to increase after physical exertion, long stays on the legs, or long-term limitation of mobility. AT this case doctors at the Yusupov hospital prescribe treatment that leads to persistent regression pathological changes in the limb.

Lymphostasis moderate characterized by the following symptoms:

  • non-disappearing lymphedema;
  • growth of connective tissues;
  • tightness and tightness of the skin, which may be accompanied by pain.

After pressing with a finger on edematous tissues, impression marks remain that persist for a long time. Persistent lymphedema is the cause fatigue the affected limb and convulsions.

At severe course lymphedema, patients have irreversible violations of the outflow of lymphatic fluid, the development of fibrocystic changes in tissues and elephantiasis. Lymphostasis becomes so pronounced that the limb loses its contours and the ability to function normally.

Doctors at the Yusupov Hospital use the following diagnostic methods to identify the cause of lymphedema:

  • dopplerography;
  • computed and magnetic resonance imaging;
  • lymphangiography
  • lymphoscintigraphy with tc-99m.

Techniques for the treatment of lymphatic edema

Doctors at the Yusupov Hospital use following methods treatment of lymphatic edema:

  • complex anti-edematous therapy, including skin care;
  • manual lymphatic drainage;
  • hardware compression;
  • gymnastics;
  • bandaging.

Manual lymphatic drainage is performed by experienced massage therapists. For hardware compression, modern devices from the best European manufacturers are used. Additionally, the Yusupov hospital uses a number of unique devices and techniques for physiotherapy, for example, a device for stimulating the lymphatic vessels.

In the later stages of edema, if it does not respond to conservative treatment, the mass of the limb is physically reduced. To do this, angiosurgeons in the partner clinics of the Yusupov Hospital perform surgical procedure, in which excess fluid in the tissue is removed through small punctures using aspiration similar to liposuction.

If you find lymphatic edema, contact the Yusupov hospital. The doctors will necessary examination and decide on best method treatment of the disease. If there are indications vascular surgeons partner clinics will perform innovative surgical interventions that will help improve the quality of life and preserve the limb.

Bibliography

- This is a pathology of the lymphatic system, accompanied by impaired lymph circulation and retention of lymphatic fluid in the tissues. With lymphostasis, tissue thickening, persistent edema and a noticeable thickening of the limb (lymphedema), skin ulcers occur. Determination of the cause of lymphostasis requires an ultrasound of the pelvis, abdominal cavity, limb vessels, radiography chest, lymphography, lymphoscintigraphy. Treatment of lymphostasis can be non-surgical (massage, compression therapy, hirudotherapy, medicines) and surgical (reconstruction of lymphovenous anastomoses).

X-ray lymphography, lymphoscintigraphy with Tc-99m, MRI, CT are used to determine the location of the lymphatic block and the patency of the vessels. These techniques make it possible to judge changes in the lymphatic bed, identify areas of tortuosity, lymphangiectasia, and valvular insufficiency.

Lymphostasis is differentiated from deep vein thrombosis and postphlebitic syndrome, in which the lymphedema is unilateral, the edema is mild, the presence of hyperpigmentation is determined, varicose eczema and varicose veins. To exclude venous pathology, ultrasound of the veins of the extremities is performed.

Treatment of lymphostasis

The goal of treating lymphostasis is to restore the outflow of lymph from the limbs or other organs. With lymphostasis, the appointment of manual lymphatic drainage massage, hardware pneumocompression, physiotherapy (magnetic therapy, laser therapy, hydromassage), selection and wearing compression stockings. The patient is advised to follow a salt-restricted diet, exercise physical therapy, swimming, Nordic walking. From drug therapy phlebotonics with lymphotropic action, enzymes, angioprotectors, immunostimulants are used. At trophic ulcers and eczema are treated locally.

With lymphostasis, it is necessary to carefully care for the feet in order to prevent the development of lymphangitis. For this purpose, it is better to perform a medical hardware pedicure using special means for hygiene and curative care behind your feet. With the development of a fungal infection, antimycotic agents are prescribed, treatment of the legs with antifungal drugs.

Grounds for surgical treatment lymphostasis can serve as the inefficiency of complex conservative therapy, progression of lymphedema, the presence of severe fibrosis and deforming lymphatic sacs. With lymphostasis, they resort to microsurgical creation of lymphovenous anastomoses, liposuction and dermatofasciolipectomy.

In the case of primary lymphedema, transplantation of a full-fledged tissue lymphoid complex is indicated. With severe elephantiasis, which excludes the possibility of radical operations, tunneling of the affected areas is performed to divert lymph into healthy tissues, resection interventions.

Forecast and prevention

Failure to treat lymphedema contributes to even greater lymphatic tissue edema, impaired limb mobility, development chronic infection. Regardless of the stage at which lymphostasis was diagnosed, patients require supervision by an angiosurgeon. Course maintenance therapy for lymphostasis should be carried out for life.

Careful care of the skin of the hands and feet allows preventing violation of lymph circulation in the limbs, timely treatment any wounds and prevent their infection. treatment for kidney, heart, venous vessels in order to avoid decompensation of pathology. To prevent the development of postoperative lymphedema in last years in mammology abandoned total lymph node dissection during radical mastectomy and are limited to the removal of sentinel lymph nodes.

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