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间歇气动压迫治疗对下肢水肿低活动度患者临床结局和生化标志物的影响。

Effects of intermittent pneumatic compression treatment on clinical outcomes and biochemical markers in patients at low mobility with lower limb edema.

机构信息

Department of Morphology, Surgery and Experimental Medicine, Unit of Translational Surgery, University Hospital of Ferrara, and Vascular Diseases Center, University of Ferrara, Ferrara, Italy.

Department of Morphology, Surgery and Experimental Medicine and LTTA Center, University of Ferrara, Ferrara, Italy.

出版信息

J Vasc Surg Venous Lymphat Disord. 2018 Jul;6(4):500-510. doi: 10.1016/j.jvsv.2018.01.019.

Abstract

OBJECTIVE

We aimed to evaluate the effects of intermittent pneumatic compression (IPC) in patients at low mobility with leg edema.

METHODS

A pilot, two-arm, randomized controlled clinical trial was performed. Fifty patients (age, 58.4 ± 9 years; male, 14), randomly allocated to a group (IPC) undergoing 1 month (n = 29) of an in-home cycle of IPC and to a control (C) group (n = 21), were studied. Leg edema was evaluated by measuring subcutaneous thickness (high-resolution ultrasound) and circumferences (metric tape), both assessed at different levels of the lower limbs, and volume (water plethysmography). Ankle range of motion (ROM, goniometer), quality of life (QoL) by the 36-Item Short Form Health Survey, and a pool of plasma inflammatory markers were also evaluated.

RESULTS

Edema significantly decreased in the IPC group (for all outcome measures, P < .0001), whereas it significantly increased in the C group (P < .0001). Ankle ROM was significantly enhanced in the IPC group (dorsiflexion, P < .0001; plantar flexion, P = .002) and remained stable in the C group. QoL showed an improvement in the IPC group, particularly significant for the general health subscale (P = .004), whereas no changes were highlighted in the C group. The two groups exhibited different trends and variations for some plasma inflammatory markers, mainly for granulocyte colony-stimulating factor.

CONCLUSIONS

In a sample of patients at reduced mobility with leg edema, IPC treatment was effective in reducing the edema, improving the ankle ROM, and determining a positive impact on QoL together with a slight modulation of some plasma inflammatory markers.

摘要

目的

评估间歇性气动压迫(IPC)对下肢水肿低活动度患者的影响。

方法

进行了一项试点、双臂、随机对照临床试验。50 名患者(年龄,58.4 ± 9 岁;男性,14 名)随机分配到一个组(IPC),接受 1 个月(n = 29)家庭循环 IPC,和对照组(C)(n = 21)。通过测量皮下厚度(高分辨率超声)和周长(测径规)来评估下肢不同水平的下肢水肿,并通过液体体积描记法评估体积。还评估了踝关节活动度(测角器)、生活质量(36 项简明健康调查)和一组血浆炎症标志物。

结果

IPC 组的水肿明显减少(所有结局指标,P <.0001),而 C 组的水肿明显增加(P <.0001)。IPC 组的踝关节活动度明显增强(背屈,P <.0001;跖屈,P =.002),而 C 组保持稳定。IPC 组的生活质量得到改善,特别是一般健康子量表(P =.004)显著改善,而 C 组没有变化。两组的一些血浆炎症标志物呈现出不同的趋势和变化,主要是粒细胞集落刺激因子。

结论

在一组下肢水肿活动度降低的患者中,IPC 治疗有效,可减轻水肿,改善踝关节活动度,并对 QoL 产生积极影响,同时对一些血浆炎症标志物有轻微调节。

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