乳腺癌相关淋巴水肿患者中综合消肿物理治疗与星状神经节阻滞联合曲安奈德给药的疗效比较。

A comparison of the effectiveness of complex decongestive physiotherapy and stellate ganglion block with triamcinolone administration in breast cancer-related lymphedema patients.

作者信息

Kim Jeong-Gil, Bae Soon Ook, Seo Kwan Sik

机构信息

Department of Rehabilitation Medicine, College of Medicine, Seoul National University, 101 Daehak-ro Jongno-gu, Seoul, 110-744, South Korea.

出版信息

Support Care Cancer. 2015 Aug;23(8):2305-10. doi: 10.1007/s00520-014-2593-5. Epub 2015 Jan 11.

DOI:10.1007/s00520-014-2593-5

PMID:25577504

Abstract

PURPOSE

This study aims to investigate the comparison of effectiveness between stellate ganglion block (SGB) and complex decongestive physiotherapy (CDT) in breast cancer-related lymphedema (BCRL) patients.

METHODS

The study is a retrospective matched cohort study. A total of 60 subjects who had secondary lymphedema after breast cancer treatments were included in this study. Thirty subjects who had SGB were matched with other 30 subjects treated with CDT, which is the standard therapy for BCRL. The groups were matched for age, duration of lymphedema, type of surgery, and history of lymph node dissection. SGB subjects received SGB three times, once every 2 weeks and CDT subjects were treated for 2 weeks. The circumferences of the forearm and upper arm were used as the outcome variable. These parameters were measured with baseline value before each treatment and repeated the evaluation after the treatments. We investigated the difference of circumferences within each treatment and compared the clinical effect between treatments.

RESULTS

Sixty subjects (mean age 58.2 ± 8.7) were treated with CDT and SGB each. There was no significant difference in demographic data including cancer treatment. The mean circumferences of the forearm and upper arm after CDT significantly reduced; forearm from 24.91 to 23.87 cm and upper arm from 30.52 to 29.58 cm (p < 0.001). And the clinical effect of SGB was also significant; forearm from 24.90 to 23.64 cm and upper arm from 30.96 to 29.16 cm (p < 0.001). The differences of the forearm between CDT and SGB was not significant, but the circumference of the upper arm was more reduced after SGB treatment (1.81 ± 1.21 cm) than CDT (0.94 cm ± 0.78 cm) (p < 0.01).

CONCLUSIONS

SGB is an effective treatment which can reduce the circumference of arm in breast cancer-related lymphedema patients and could be an alternative treatment for lymphedema.

摘要

目的

本研究旨在调查星状神经节阻滞（SGB）与综合消肿物理治疗（CDT）对乳腺癌相关淋巴水肿（BCRL）患者的疗效比较。

方法

本研究为回顾性匹配队列研究。共有60例乳腺癌治疗后出现继发性淋巴水肿的患者纳入本研究。30例行SGB治疗的患者与另外30例接受CDT治疗（BCRL的标准治疗方法）的患者进行匹配。两组在年龄、淋巴水肿持续时间、手术类型和淋巴结清扫史方面进行匹配。SGB组患者接受3次SGB治疗，每2周1次，CDT组患者接受2周治疗。以前臂和上臂周长作为结果变量。在每次治疗前测量这些参数的基线值，并在治疗后重复评估。我们研究了每种治疗方法中周长的差异，并比较了不同治疗方法之间的临床效果。

结果

每组60例患者（平均年龄58.2±8.7）分别接受了CDT和SGB治疗。包括癌症治疗在内的人口统计学数据无显著差异。CDT治疗后前臂和上臂的平均周长显著减小；前臂从24.91厘米减至23.87厘米，上臂从30.52厘米减至29.58厘米（p<0.001）。SGB的临床效果也很显著；前臂从24.90厘米减至23.64厘米，上臂从30.96厘米减至29.16厘米（p<0.001）。CDT和SGB治疗后前臂周长的差异不显著，但SGB治疗后上臂周长的减小幅度（1.81±1.21厘米）大于CDT（0.94厘米±0.78厘米）（p<0.01）。