Keast David H, Despatis Marc, Allen Jill O, Brassard Alain
Aging, Rehabilitation and Geriatric Care Research Centre, Lawson Health Research Institute, St. Joseph's Parkwood Hospital, London, Ontario, Canada.
Vascular Surgery at Centre hospitalier de l'Université de Sherbrooke, Université de Sherbrooke, Sherbrooke, Québec, Canada.
Int Wound J. 2015 Jun;12(3):328-33. doi: 10.1111/iwj.12224. Epub 2014 Feb 12.
Even though it is estimated that at least 300 000 people in Canada may be affected by chronic oedema/lymphoedema, recognition of the seriousness of this chronic disease in health care is scarce. Lymphoedema affects up to 70% of breast and prostate cancer patients, substantially increasing their postoperative medical costs. Adding to this problem are the escalating rates of morbid obesity across North America and the fact that 80% of these individuals are thought to suffer with an element of lymphoedema. The costs related to these patient populations and their consumption of health care resources are alarming. Untreated chronic oedema/lymphoedema is progressive and leads to infection, disfigurement, disability and in some cases even death. Thus, prognosis for the patient is far worse and treatment is more costly when the disease is not identified and treated in the earlier stages. Although the number of individuals coping with chronic oedema/lymphoedema continues to increase, the disparity between diagnosis, treatment and funding across Canada endures. The reasons for this include a lack of public awareness of the condition, insufficient education and knowledge among health care providers regarding aetiology and management and limited financial coverage to support appropriate methods and materials.
尽管据估计加拿大至少有30万人可能受到慢性水肿/淋巴水肿的影响,但医疗保健领域对这种慢性病严重性的认识却很匮乏。淋巴水肿影响高达70%的乳腺癌和前列腺癌患者,大幅增加了他们术后的医疗费用。北美病态肥胖率不断攀升,且80%的这类患者被认为患有某种程度的淋巴水肿,这使得问题更加严重。与这些患者群体及其医疗资源消耗相关的成本令人担忧。未经治疗的慢性水肿/淋巴水肿会不断发展,导致感染、毁容、残疾,在某些情况下甚至死亡。因此,如果疾病在早期未被识别和治疗,患者的预后会差得多,治疗成本也会更高。尽管应对慢性水肿/淋巴水肿的人数持续增加,但加拿大各地在诊断、治疗和资金方面的差距依然存在。其原因包括公众对该病缺乏认识、医疗保健提供者对病因和管理的教育及知识不足,以及支持适当方法和材料的资金覆盖有限。