Vanderbilt University School of Nursing, 461 21st Avenue South, Godchaux Hall, Nashville, TN 37240, USA.
Breast Cancer Res Treat. 2012 Jan;131(1):147-58. doi: 10.1007/s10549-011-1795-5. Epub 2011 Sep 30.
Treatment of the truncal lymphatics prior to treatment of the lymphedematous arm is an accepted, although not empirically tested, therapeutic intervention delivered during decongestive lymphatic therapy (DLT). Breast cancer survivors with arm lymphedema are encouraged to use these techniques when performing simple lymphatic drainage as part of their life-long lymphedema self-care. Self-massage is at times difficult and pneumatic compression devices are used by many patients to assist with self-care. One such device, the Flexitouch(®) System, replicates the techniques used during DLT; however, the need for application of pneumatic compression in unaffected truncal areas to improve self-care outcomes in arm only lymphedema is not established. The objective of this study was to compare the therapeutic benefit of truncal/chest/arm advanced pneumatic compression therapy (experimental group) verses arm only pneumatic compression (control group) in self-care for arm lymphedema without truncal involvement using the Flexitouch(®) System. Outcomes of interest were self-reported symptoms, function, arm impedance ratios, circumference, volume, and trunk circumference. Forty-two breast cancer survivors, (21 per group), with Stage II lymphedema completed 30 days of home self-care using the Flexitouch(®) System. Findings revealed a statistically significant reduction in both the number of symptoms and overall symptom burden within each group; however, there were no statistically significant differences in these outcomes between the groups. There was no statistically significant overall change or differential pattern of change between the groups in function. A statistically significant reduction in bioelectrical impedance and arm circumference within both of the groups was achieved; however, there was no statistically significant difference in reduction between groups. These findings indicate that both configurations are effective, but that there may be no added benefit to advanced pneumatic treatment of the truncal lymphatics prior to arm massage when the trunk is not also affected. Further research is indicated in a larger sample.
在进行淋巴水肿治疗之前，对躯干淋巴管进行治疗是一种被接受的治疗干预措施，尽管尚未经过实证检验，这种治疗方法在减压淋巴治疗（Decongestive Lymphatic Therapy，DLT）中得到应用。患有上肢淋巴水肿的乳腺癌幸存者被鼓励在进行简单的淋巴引流时使用这些技术，这是他们终身淋巴水肿自我护理的一部分。自我按摩有时很困难，许多患者使用气动压缩设备来协助自我护理。Flexitouch（R）系统就是这样一种设备，它复制了 DLT 中使用的技术；然而，在仅上肢淋巴水肿中，为了改善自我护理效果，在未受影响的躯干区域应用气动压缩来改善自我护理效果的需求尚未得到证实。本研究的目的是比较躯干/胸部/上肢高级气动压缩治疗（实验组）与仅上肢气动压缩（对照组）在使用 Flexitouch（R）系统进行自我护理时对无躯干受累的上肢淋巴水肿的治疗效果。感兴趣的结果包括自我报告的症状、功能、手臂阻抗比、周长、体积和躯干周长。42 名患有 II 期淋巴水肿的乳腺癌幸存者（每组 21 名）完成了 30 天的 Flexitouch（R）系统家庭自我护理。研究结果显示，两组患者的症状数量和总体症状负担均有统计学显著减少；然而，两组之间的这些结果没有统计学显著差异。两组在功能方面没有统计学显著的整体变化或差异模式。两组的生物电阻抗和手臂周长均有统计学显著减少；然而，两组之间的减少没有统计学显著差异。这些发现表明，两种配置都有效，但在躯干不受影响的情况下，在手臂按摩之前对躯干淋巴管进行高级气动治疗可能没有额外的益处。需要在更大的样本中进行进一步研究。
