Mayrovitz H N, Sims N, Hill C J, Hernandez T, Greenshner A, Diep H
College of Medical Sciences, Nova Southeastern University, Ft Lauderdale, Florida 33328, USA.
Lymphology. 2006 Jun;39(2):95-103.
Assessing changes in upper extremity limb volume during lymphedema therapy is important for determining treatment efficacy and documenting outcomes. Although arm volumes may be determined by tape measure, the suitability of circumference measurements to estimate hand volumes is questionable because of the deviation in circularity of hand shape. Our aim was to develop an alternative measurement procedure and algorithm for routine use to estimate hand volumes. A caliper was used to measure hand width and depth in 33 subjects (66 hands) and volumes (VE) were calculated using an elliptical frustum model. Using regression analysis and limits of agreement (LOA), VE was compared to volumes determined by water displacement (VW), to volumes calculated from tape-measure determined circumferences (VC), and to a trapezoidal model (VT). VW and VE (mean +/- SD) were similar (363 +/- 98 vs. 362 +/-100 ml) and highly correlated; VE = 1.01VW -3.1 ml, r=0.986, p<0.001, with LOA of +/- 33.5 ml and +/- 9.9 %. In contrast, VC (480 +/- 138 ml) and VT (432 +/- 122 ml) significantly overestimated volume (p<0.0001). These results indicate that the elliptical algorithm can be a useful alternative to water displacement when hand volumes are needed and the water displacement method is contra-indicated, impractical to implement, too time consuming or not available.
评估淋巴水肿治疗期间上肢肢体体积的变化对于确定治疗效果和记录结果非常重要。尽管手臂体积可以通过卷尺测量，但由于手部形状的圆形度偏差，用周长测量来估计手部体积的适用性值得怀疑。我们的目的是开发一种替代测量程序和算法，以便常规用于估计手部体积。使用卡尺测量了33名受试者（66只手）的手部宽度和深度，并使用椭圆台模型计算体积（VE）。通过回归分析和一致性界限（LOA），将VE与通过排水法测定的体积（VW）、根据卷尺测量的周长计算的体积（VC）以及梯形模型（VT）进行比较。VW和VE（平均值±标准差）相似（363±98 vs. 362±100 ml）且高度相关；VE = 1.01VW - 3.1 ml，r = 0.986，p < 0.001，LOA为±33.5 ml和±9.9%。相比之下，VC（480±138 ml）和VT（432±122 ml）显著高估了体积（p < 0.0001）。这些结果表明，当需要手部体积且排水法禁忌、实施不切实际、耗时过长或无法使用时，椭圆算法可以作为排水法的一种有用替代方法。
