Moffatt Christine J, Keeley Vaughan, Hughes Andrew, Clark Kath, Lisle Jill, Benson Margaret, Gaskin Rebecca, Sykorova Martina, Dring Eleanor, Murray Susie, Mercier Gregoire, Quere Isabelle, Franks Peter J
1 School of Social Sciences, Nottingham Trent University, Nottingham, United Kingdom.
2 Montpellier Medecine Vasculaire, EA2992, Universite Montpellier I, CHU Saint Eloi, Montpellier, France.
Lymphat Res Biol. 2019 Apr;17(2):211-220. doi: 10.1089/lrb.2019.0020.
This study was undertaken as part of the UK LIMPRINT international study to determine the number of people with chronic edema (CO) and its impact on health services. Overall 7436 with CO were recruited in the main UK study from a range of health settings. Factors relating to subjective control of arm and leg CO were defined in the UK. A total of 1565 patients were included in the study with exclusions for: no limb swelling or not recorded (1669), having concurrent arm/leg CO (272), control of assessment missing (5) and professional being unsure of control status of CO (325). Arm swelling occurred in 953 (18.5%) with leg CO in 4212 (81.5%). Poor control was found in 1430 (27.2%) and good control in 3735 (72.3%). Control of arm swelling was worse in men and control increased overall in those aged over 45 years. In contrast control of CO worsened in those with leg CO with increasing age and multiple co-morbidities. Obesity and cellulitis, particularly an episode in the last year were associated with poor control. Independent risk factors for arm CO were : obesity, neurological disease and cellulitis in the last year and for leg CO, obesity, poor mobility, heart disease, presence of a wound, cellulitis in the last year and duration of swelling. Control of CO within specialized centers is complex due to sociodemographic and clinical comorbidities.
本研究作为英国LIMPRINT国际研究的一部分开展，旨在确定慢性水肿（CO）患者的数量及其对卫生服务的影响。在英国的主要研究中，从一系列卫生机构招募了总计7436名患有CO的患者。在英国定义了与手臂和腿部CO主观控制相关的因素。共有1565名患者纳入研究，排除标准为：无肢体肿胀或未记录（1669例）、同时存在手臂/腿部CO（272例）、评估控制缺失（5例）以及专业人员不确定CO的控制状态（325例）。953例（18.5%）出现手臂肿胀，4212例（81.5%）出现腿部CO。发现1430例（27.2%）控制不佳，3735例（72.3%）控制良好。男性手臂肿胀的控制情况较差，45岁以上人群的总体控制情况有所改善。相比之下，腿部CO患者的控制情况随年龄增长和多种合并症而恶化。肥胖和蜂窝织炎，尤其是去年发作的情况与控制不佳有关。手臂CO的独立危险因素为：肥胖、神经疾病和去年的蜂窝织炎；腿部CO的独立危险因素为：肥胖、行动不便、心脏病、伤口存在、去年的蜂窝织炎和肿胀持续时间。由于社会人口统计学和临床合并症，专科中心内CO的控制较为复杂。
