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仰卧位与站立位生物阻抗设备评估乳腺癌相关淋巴水肿的比较。

A Comparison of Supine Versus Stand-on Bioimpedance Devices to Assess Breast Cancer-Related Lymphedema.

机构信息

Department of Physiological Nursing, School of Nursing, University of California San Francisco, San Francisco, California, USA.

Department of Medicine, School of Medicine, University of California San Francisco, San Francisco, California, USA.

出版信息

Lymphat Res Biol. 2021 Dec;19(6):553-561. doi: 10.1089/lrb.2020.0058. Epub 2021 Feb 9.

Abstract

While supine bioimpedance devices are used to evaluate for lymphedema (LE), stand-on devices are gaining popularity. Because research on differences in bioimpedance values between the two devices is limited, this study's purposes were to: (1) determine the average upper limb impedance values and inter-limb ratios for women who self-reported having ( = 34) or not having ( = 61) a history of LE, using a single-frequency supine device and a multifrequency stand-on device; (2) compare the level of agreement in inter-limb impedance ratios between the two devices; evaluate the percent agreement between the two devices in classifying cases of LE using established supine thresholds; and evaluate the percent agreement in classifying cases of LE between the supine device using previously established supine thresholds and the stand-on device using two published standing thresholds. Bioimpedance measures were done using the two devices. For the entire sample, absolute impedance values for both the affected and unaffected limbs were significantly higher for the stand-on device in women with and without LE. Impedance values for the two methods were highly correlated. Bland-Altman analysis determined that for the entire range of impedance ratios the values for the two devices could not be used interchangeably. Findings suggest that the stand-on device can be a useful and valid tool to assess for LE. However, because agreement is not perfect, values obtained from the two devices should not be used interchangeably to evaluate for changes in impedance ratios, particularly for ratios of >1.20.

摘要

当使用仰卧式生物阻抗设备评估淋巴水肿 (LE) 时,站立式设备越来越受欢迎。由于关于两种设备之间生物阻抗值差异的研究有限,本研究的目的是:(1) 使用单频仰卧式设备和多频站立式设备,确定报告有 ( = 34) 或没有 ( = 61) LE 病史的女性上肢的平均阻抗值和肢体间比值;(2) 比较两种设备在肢体间阻抗比值的一致性水平;评估两种设备在使用既定仰卧式阈值分类 LE 病例方面的百分比一致性;并评估使用既定仰卧式阈值的仰卧式设备和使用两个已发表的站立式阈值的站立式设备在 LE 病例分类方面的百分比一致性。使用两种设备进行生物阻抗测量。对于整个样本,在有和没有 LE 的女性中,站立式设备的患侧和健侧的绝对阻抗值均明显高于仰卧式设备。两种方法的阻抗值高度相关。Bland-Altman 分析确定,在整个阻抗比值范围内,两种设备的值不能互换使用。研究结果表明,站立式设备可作为评估 LE 的有用且有效的工具。然而,由于一致性不是完美的,因此不应互换使用两种设备获得的值来评估阻抗比值的变化,尤其是比值 >1.20 时。

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本文引用的文献

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Diagnosis of upper limb lymphedema: development of an evidence-based approach.上肢淋巴水肿的诊断:循证方法的发展
Acta Oncol. 2016 Dec;55(12):1477-1483. doi: 10.1080/0284186X.2016.1191668. Epub 2016 Jun 22.

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