Falk Cardiovascular Research Center, Stanford University, Stanford, CA.
Nashville Breast Center, Nashville, TN.
J Vasc Surg Venous Lymphat Disord. 2022 Nov;10(6):1359-1366.e1. doi: 10.1016/j.jvsv.2022.06.016. Epub 2022 Aug 8.
Advanced pneumatic compression devices (APCDs) have been shown to be an effective intervention for lymphedema when used as part of a self-care maintenance treatment regimen. However, adherence to self-care has been poor, and APCDs require patients to be immobile during treatment. We evaluated the safety and efficacy of a novel nonpneumatic compression device (NPCD) for treating lymphedema vs an APCD.
A randomized, crossover head-to-head investigation was performed at five U.S. sites in 2021. The patients had been randomized to either the NPCD or a commercially available APCD. The patients used the randomly assigned initial device for 28 days with a 4-week washout period before a comparable 28-day use of the second device.
Data from 50 adult women with unilateral breast cancer-related lymphedema were analyzed. Compared with the APCD, the NPCD was associated with a greater mean reduction in the limb edema volume (64.6% vs 27.7%; P < .001), significantly greater mean improvements in quality of life scores, greater adherence (95.6% vs 49.8%; P < .001), and greater satisfaction with the device (90% vs 14%; P < .001). The patients indicated that use of the NPCD facilitated exercise and was convenient for travel. No adverse events were reported.
The results have shown that the novel NPCD is an effective maintenance treatment for reducing the limb volume in patients with breast cancer-related lymphedema. The NPCD device was more effective than an APCD and resulted in greater adherence to self-care interventions and greater patient satisfaction.
当作为自我护理维持治疗方案的一部分时,先进的气动压缩设备 (APCD) 已被证明是治疗淋巴水肿的有效干预措施。然而,自我护理的依从性一直很差,并且 APCD 需要患者在治疗期间保持不动。我们评估了一种新型非气动压缩设备 (NPCD) 与 APCD 治疗淋巴水肿的安全性和有效性。
2021 年在美国五个地点进行了一项随机、交叉头对头研究。患者已随机分配到 NPCD 或市售 APCD。患者使用随机分配的初始设备 28 天,然后有 4 周的洗脱期,然后再使用第二个设备 28 天。
分析了来自 50 名患有单侧乳腺癌相关淋巴水肿的成年女性的数据。与 APCD 相比,NPCD 与肢体水肿体积的平均减少量更大(64.6%比 27.7%;P<.001),生活质量评分的平均改善更大,依从性更高(95.6%比 49.8%;P<.001),以及对设备的满意度更高(90%比 14%;P<.001)。患者表示,使用 NPCD 方便进行运动,并且便于旅行。未报告不良事件。
结果表明,新型 NPCD 是一种有效的维持治疗方法,可减少乳腺癌相关淋巴水肿患者的肢体体积。NPCD 设备比 APCD 更有效,可提高自我护理干预措施的依从性和患者满意度。