Graduate School of Medical Sciences, Division of Health Sciences, Graduate Course of Nursing Science, Kanazawa University, Kanazawa, Japan.
Department of Clinical Nursing, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan.
Int J Nurs Stud. 2015 May;52(5):913-9. doi: 10.1016/j.ijnurstu.2015.01.011. Epub 2015 Feb 18.
Lymphoedema is not currently curable, and it is important that symptoms are alleviated by appropriate treatment. Treatments aim to delay the progression of swelling and to improve patients' quality of life (QOL). There are many objective and subjective outcomes of lymphoedema, but it is unclear which outcomes should be used to evaluate lymphoedema treatments.
This study aimed to examine the associations between lymphoedema treatments and outcomes.
A cross-sectional observational study.
Lymphoedema outpatient clinics in Japan.
A total of 170 patients with lymphoedema were recruited from four outpatient clinics.
The data were collected from medical records, physical assessments, and interviews. The following objective outcomes were evaluated: circumference measurements, Stemmer sign, cellulitis, and skin hardness. The following subjective outcomes were evaluated: satisfaction with treatment, subjective symptoms, EuroQol-5 dimensions, and a quality of life measure for limb lymphoedema (LYMQOL). Multiple regression analysis was performed to examine the associations between lymphoedema treatments and their outcomes.
Secondary lymphoedema was present in 158 patients (92.9%), and 91 patients (53.5%) had lower lymphoedema. The patients using compression garments were 2.63 times more likely to have a positive Stemmer sign and 2.85 times more likely to be satisfied with their treatment than those who were not using compression garments (p=0.02 for Stemmer sign, p<0.01 for satisfaction). The patients treated with simple lymphatic drainage (SLD) exhibited a 2.26-fold greater level of satisfaction with treatment than those not receiving this treatment (p<0.01). The patients treated with complete decongestive therapy (CDT) had higher QOL than did those not receiving this therapy (β=-0.19, p=0.04).
The progression of swelling can be evaluated using the Stemmer sign with regard to compression therapy. The degree of satisfaction can be evaluated as the patient's satisfaction with their lymphoedema regarding compression garments and SLD, and improvements in QOL can be evaluated using the LYMQOL with regard to CDT. The subjective outcomes were not associated with every lymphoedema treatment in this study, and the effectiveness of lymphoedema treatment can be evaluated using several different outcomes.
淋巴水肿目前无法治愈，通过适当的治疗缓解症状非常重要。治疗旨在延缓肿胀的进展，提高患者的生活质量（QOL）。淋巴水肿有许多客观和主观的结果，但尚不清楚应该使用哪些结果来评估淋巴水肿的治疗效果。
本研究旨在探讨淋巴水肿治疗与结果之间的关系。
横断面观察性研究。
日本淋巴水肿门诊诊所。
共从四家门诊诊所招募了 170 名淋巴水肿患者。
数据来自病历、体格检查和访谈。评估了以下客观结果：周长测量、Stemmer 征、蜂窝织炎和皮肤硬度。评估了以下主观结果：对治疗的满意度、主观症状、EuroQol-5 维度和肢体淋巴水肿生活质量量表（LYMQOL）。采用多元回归分析探讨淋巴水肿治疗与结果之间的关系。
158 名患者（92.9%）存在继发性淋巴水肿，91 名患者（53.5%）存在下肢淋巴水肿。与未使用压迫性衣物的患者相比，使用压迫性衣物的患者Stemmer 征阳性的可能性高 2.63 倍，对治疗的满意度高 2.85 倍（Stemmer 征，p=0.02；满意度，p<0.01）。与未接受单纯淋巴引流（SLD）治疗的患者相比，接受 SLD 治疗的患者对治疗的满意度高 2.26 倍（p<0.01）。与未接受完整减压治疗（CDT）的患者相比，接受 CDT 的患者的生活质量更高（β=-0.19，p=0.04）。
肿胀的进展可以使用压迫疗法的 Stemmer 征进行评估。患者对压迫性衣物和 SLD 治疗淋巴水肿的满意度可作为评估满意度的指标，使用 CDT 治疗后，生活质量可以通过 LYMQOL 进行评估。在本研究中，主观结果与并非所有的淋巴水肿治疗都相关，并且可以使用几种不同的结果来评估淋巴水肿治疗的效果。
