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间歇性气动压迫联合低强度激光治疗对乳腺癌改良根治术后上肢淋巴水肿的长期疗效:一项随机对照试验

Long-Term Effectiveness of Combined Intermittent Pneumatic Compression Plus Low-Level Laser Therapy in Patients with Postmastectomy Lymphedema: A Randomized Controlled Trial.

作者信息

Kozanoglu Erkan, Gokcen Neslihan, Basaran Sibel, Paydas Semra

机构信息

Department of Physical Medicine and Rehabilitation, Cukurova University Faculty of Medicine, Adana, Turkey.

Division of Rheumatology, Department of Physical Medicine and Rehabilitation, Cukurova University Faculty of Medicine, Adana, Turkey.

出版信息

Lymphat Res Biol. 2022 Apr;20(2):175-184. doi: 10.1089/lrb.2020.0132. Epub 2021 Apr 7.

DOI:10.1089/lrb.2020.0132
PMID:33826415
Abstract

Upper limb lymphedema may be revealed after breast cancer and its treatment. Among different treatment approaches, intermittent pneumatic compression (IPC) therapy and low-level laser therapy (LLLT) are reported as effective modalities in the treatment of postmastectomy upper limb lymphedema (PML). The aim of the current study is to investigate the long-term effectiveness of combined IPC plus LLLT versus IPC therapy alone in patients with PML. The patients were allocated into two groups in this single-blinded, controlled clinical trial. Group I received combined treatment with IPC plus LLLT ( = 21) and group II received only IPC ( = 21). IPC treatment was given 5 sessions per week for 4 weeks (20 sessions). LLLT was also performed 5 sessions per week for 4 weeks (20 sessions). Clinical evaluations were performed before and after the treatment at the 3, 6, and 12-month follow-up visits. According to within-group analysis, statistically significant improvements in the circumference difference () and grip strength were observed in both groups (for ,  = 0.018 and  = 0.032, respectively; for grip strength,  = 0.001 and  = 0.046, respectively). Visual analog scale values for arm pain and shoulder pain during motion were decreased only in group I. Both interventions have positive effects on lymphedema, grip strength, and pain. Long-term effects of combined therapy, especially on pain, are slightly superior to the pneumatic compression alone.

摘要

上肢淋巴水肿可能在乳腺癌及其治疗后出现。在不同的治疗方法中,间歇性气动压迫(IPC)疗法和低强度激光疗法(LLLT)被报道为治疗乳房切除术后上肢淋巴水肿(PML)的有效方式。本研究的目的是调查IPC联合LLLT与单纯IPC疗法相比,对PML患者的长期疗效。在这项单盲对照临床试验中,患者被分为两组。第一组接受IPC联合LLLT治疗(n = 21),第二组仅接受IPC治疗(n = 21)。IPC治疗每周进行5次,共4周(20次)。LLLT也每周进行5次,共4周(20次)。在治疗前以及治疗后3、6和12个月的随访中进行临床评估。根据组内分析,两组的周径差(p值分别为0.018和0.032)和握力(p值分别为0.001和0.046)均有统计学意义的改善。仅在第一组中,运动时手臂疼痛和肩部疼痛的视觉模拟量表值有所下降。两种干预措施对淋巴水肿、握力和疼痛均有积极影响。联合治疗的长期效果,尤其是对疼痛的效果,略优于单纯气动压迫疗法。

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