Ridner S H, Montgomery L D, Hepworth J T, Stewart B R, Armer J M
School of Nursing, Vanderbilt University, Nashville, Tennessee 37240, USA.
Lymphology. 2007 Mar;40(1):35-46.
Lymphedema is a problem for breast cancer survivors. The proliferation of limb measurement techniques makes it difficult to know how best to measure an at-risk limb. Using a sample of healthy volunteers and individuals with lymphedema, this study: 1) examined the relationship between more commonly used circumferential limb measurement methods and newer measurement methods of infrared laser perometry and bioelectrical impedance; 2) compared self-reported arm symptoms in healthy volunteers and breast cancer survivors with known lymphedema; and 3) explored the relationships among self-reported arm symptoms and circumferential tape measurement, infrared laser (perometry), and single and multi-frequency bioelectrical impedance. Lymphedema index ratios were calculated to allow comparison among measurement methods. Measurement methods correlated strongly with each other. Fourteen symptoms were reported by one or more participants in the lymphedema group while participants in the healthy volunteer group reported only eight symptoms over the same time frames. Using p < 0.001, all measurement methods correlated with self-reported arm swelling in the past year, while only circumferential and impedance measurements correlated with firmness. Future research needs to include serial arm measurements to explore arm volume variation in healthy and lymphedema volunteers and to further investigate possible lymphedema index ratios cut points as lymphedema diagnostic criteria.
淋巴水肿是乳腺癌幸存者面临的一个问题。肢体测量技术的增多使得难以知晓如何以最佳方式测量有风险的肢体。本研究以健康志愿者和淋巴水肿患者为样本:1)考察了更常用的肢体周径测量方法与较新的红外激光周边测量法和生物电阻抗测量法之间的关系;2)比较了健康志愿者以及已知患有淋巴水肿的乳腺癌幸存者自我报告的手臂症状;3)探究了自我报告的手臂症状与周径卷尺测量、红外激光(周边测量法)以及单频和多频生物电阻抗之间的关系。计算了淋巴水肿指数比,以便在测量方法之间进行比较。测量方法之间相关性很强。淋巴水肿组中有一名或多名参与者报告了14种症状,而健康志愿者组的参与者在相同时间段内仅报告了8种症状。使用p < 0.001,所有测量方法均与过去一年中自我报告的手臂肿胀相关,而只有周径测量和阻抗测量与硬度相关。未来的研究需要纳入连续的手臂测量,以探究健康志愿者和淋巴水肿志愿者的手臂体积变化,并进一步研究作为淋巴水肿诊断标准的可能的淋巴水肿指数比切点。