Ochalek Katarzyna, Partsch Hugo, Gradalski Tomasz, Szygula Zbigniew
1 Department of Clinical Rehabilitation, Faculty of Motor Rehabilitation, University of Physical Education, Krakow, Poland.
2 Lymphoedema Clinic, St. Lazarus Hospice, Krakow, Poland.
Lymphat Res Biol. 2019 Feb;17(1):70-77. doi: 10.1089/lrb.2018.0006. Epub 2018 Oct 19.
In a previous randomized controlled trial it has been demonstrated that arm compression sleeves worn immediately after breast cancer surgery, including axillary lymph node removal in addition to physical therapy are able to reduce the occurrence of early postoperative swelling and of arm lymphedema up to 1 year and to improve quality of life. The aim of the present investigation was to check the further development of the arm swelling in patients using compression sleeves or not, and to compare the quality of life in women treated due to breast cancer 2 years after surgery.
Twenty from originally 23 patients who still wore their compression sleeves (15 mmHg) and 21 from 22 patients who had been randomized into the control group without compression could be seen after one more year. Arm volume measurements were performed and quality of life (QLQ-C30 and QLQ-BR23 questionnaires) was assessed.
Three from 20 patients in the compression group (CG) and 6 from 21 without compression showed arm lymphedema, defined by an increase of the arm volume exceeding 10% compared with the preoperative values. Significant improvement of several quality of life parameters were found in the CG.
Light compression sleeves worn for 2 years are not only able to reduce the incidence of early postoperative edema and of lymphedema, but also lead to a significant improvement of important quality-of-life parameters like physical functioning, fatigue, pain, arm and breast symptoms, and future perspectives.
在先前的一项随机对照试验中已证明,乳腺癌手术后立即佩戴手臂加压袖套,包括腋窝淋巴结清扫术,再加上物理治疗,能够降低术后早期肿胀和手臂淋巴水肿的发生率,长达1年,并改善生活质量。本研究的目的是检查使用或不使用加压袖套的患者手臂肿胀的进一步发展情况,并比较乳腺癌手术后2年接受治疗的女性的生活质量。
在又过了一年后,能见到最初23名仍佩戴加压袖套(15mmHg)的患者中的20名,以及随机分配到无加压对照组的22名患者中的21名。进行了手臂体积测量并评估了生活质量(QLQ-C30和QLQ-BR23问卷)。
加压组(CG)的20名患者中有3名,未加压组的21名患者中有6名出现了手臂淋巴水肿,定义为手臂体积比术前值增加超过10%。在CG组中发现几个生活质量参数有显著改善。
佩戴2年的轻度加压袖套不仅能够降低术后早期水肿和淋巴水肿的发生率,还能显著改善诸如身体功能、疲劳、疼痛、手臂和乳房症状以及未来展望等重要生活质量参数。