Department of Health Sciences, Division of Physiotherapy, Lund University, Lund, Sweden.
Bräcke Diakoni, Rehabcenter Sfären, Solna, Sweden.
Lymphat Res Biol. 2020 Aug;18(4):340-350. doi: 10.1089/lrb.2018.0065. Epub 2019 Dec 5.
Lymphedema may impact patients' health-related quality of life (HRQoL). The purpose of this study was to evaluate HRQoL after two different treatments to the 12-month follow-up point. Study participants were patients with moderate lymphedema in the upper or lower limb who attended a Swedish rehabilitation program (RP) undergoing conservative treatment, or those with severe, chronic lymphedema dominated by excess adipose tissue, who underwent liposuction (LS) combined with controlled compression therapy (CCT) in Australia, Scotland, or Sweden. The patients completed the Lymphedema Quality of Life Inventory (LyQLI) before intervention and after 1, 3, 6, and 12 months. Mean values and standard deviations were calculated for total limb volume and excess limb volume. Mean values were also calculated for the three LyQLI domains (physical, psychosocial, and practical). To detect and analyze differences in LyQLI responses in the three domains, the Wilcoxon signed rank test was performed. In the RP, 18 eligible patients completed the LyQLI. The results show improvements in HRQoL in physical ( = 0.003) and psychosocial domains ( = 0.002) at 1 month after the RP, with results remaining steady for 12 months for the physical domain ( = 0.024). Fifty-seven eligible LS patients completed the LyQLI. The results show improvements in HRQoL in all three domains ( < 0.001), with results remaining steady up to the 12-month follow-up ( < 0.001). The total volume in affected limb and the excess volume decreased significantly in both patient groups 1 month after intervention ( < 0.001). Treatment with a conservative RP in moderate lymphedema or with LS combined with CCT in severe lymphedema improves HRQoL.
淋巴水肿可能会影响患者的健康相关生活质量（HRQoL）。本研究的目的是在 12 个月的随访点评估两种不同治疗方法后的 HRQoL。研究参与者为上肢或下肢中度淋巴水肿的患者，他们参加了瑞典康复计划（RP），接受保守治疗，或患有严重的慢性淋巴水肿，主要由过多的脂肪组织引起，在澳大利亚、苏格兰或瑞典接受吸脂术（LS）联合控制压缩治疗（CCT）。患者在干预前和干预后 1、3、6 和 12 个月完成淋巴水肿生活质量量表（LyQLI）。计算总肢体体积和多余肢体体积的平均值和标准差。还计算了 LyQLI 的三个领域（身体、心理社会和实际）的平均值。为了检测和分析三个领域的 LyQLI 反应差异，采用 Wilcoxon 符号秩检验。在 RP 中，18 名符合条件的患者完成了 LyQLI。结果表明，RP 后 1 个月身体（ = 0.003）和心理社会领域（ = 0.002）的 HRQoL 有所改善，身体领域 12 个月的结果保持稳定（ = 0.024）。57 名符合条件的 LS 患者完成了 LyQLI。结果表明，所有三个领域的 HRQoL 都有所改善（ < 0.001），到 12 个月的随访时结果保持稳定（ < 0.001）。两种患者组在干预后 1 个月时，受影响肢体的总体积和多余体积均显著减少（ < 0.001）。中度淋巴水肿的保守 RP 治疗或严重淋巴水肿的 LS 联合 CCT 治疗可改善 HRQoL。
