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比较两种治疗乳腺癌术后淋巴水肿的方法:单纯复杂性消肿治疗与间歇性气动压迫联合治疗。

Comparing two treatment methods for post mastectomy lymphedema: complex decongestive therapy alone and in combination with intermittent pneumatic compression.

机构信息

Breast Research Department, Iranian Center for Breast Cancer, Tehran, Iran.

出版信息

Lymphology. 2010 Mar;43(1):25-33.

Abstract

There is no cure for breast cancer related lymphedema. This study was conducted to compare two treatment methods for postmastectomy lymphedema: Complex Decongestive Therapy (CDT) and Modified CDT (MCDT) combined with Intermittent Pneumatic Compression (IPC). One hundred and twelve patients referred to the Lymphedema Clinic of the Iranian Center for Breast Cancer in 2008, were included in a randomized clinical trial. They were randomly allocated into two equal groups receiving daily CDT alone or in combination with IPC. The volume reduction of the upper limb was measured by water displacement volumetry. No statistically significant differences in demographic and clinical variables between the two groups were observed. During the intensive phase (phase I) of treatment, CDT alone yielded a significantly higher mean volume reduction than the combination modality (43.1% vs. 37.5%; p = 0.036). Limb volume measured three months following treatment, showed 16.9% volume reduction by CDT alone, and 7.5% reduction by MCDT plus IPC. This study demonstrated that the use of CDT alone, or in combination with IPC significantly reduced limb volume in patients with post mastectomy lymphedema. CDT alone provided better results in both treatment phases. Further studies will help to define the role of multidisciplinary approaches in the management of postmastectomy lymphedema.

摘要

尚无治愈乳腺癌相关淋巴水肿的方法。本研究旨在比较两种乳腺癌根治术后淋巴水肿的治疗方法:复杂消肿疗法(CDT)和改良 CDT(MCDT)联合间歇性气动压迫(IPC)。2008 年,112 名患者被纳入伊朗乳腺癌中心淋巴水肿诊所的一项随机临床试验,他们被随机分为两组,分别接受每日单独 CDT 或与 IPC 联合治疗。采用水下称重法测量上肢体积减少量。两组患者的人口统计学和临床变量无统计学差异。在治疗的强化阶段(I 期),单独使用 CDT 比联合治疗方式的平均体积减少量显著更高(43.1%比 37.5%;p = 0.036)。治疗结束三个月后测量肢体体积,单独使用 CDT 可减少 16.9%的肢体体积,而 MCDT 联合 IPC 可减少 7.5%的肢体体积。本研究表明,单独使用 CDT 或联合 IPC 可显著减少乳腺癌根治术后淋巴水肿患者的肢体体积。单独使用 CDT 在两个治疗阶段都提供了更好的结果。进一步的研究将有助于确定多学科方法在乳腺癌根治术后淋巴水肿管理中的作用。

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