Department of Physical Medicine and Rehabilitation, Ankara City Hospital, University of Health Sciences, Ankara Turkey.
Department of Physical Medicine and Rehabilitation, Faculty of Medicine, University of Hacettepe, Ankara, Turkey.
Turk J Med Sci. 2022 Aug;52(4):1139-1147. doi: 10.55730/1300-0144.5417. Epub 2022 Aug 10.
Reducing lymphedema-associated burden and disability in the pediatric setting requires improved awareness and understanding clinical properties of the lymphedema. The aim of this study was to evaluate the clinical and demographic characteristics of patients with pediatric lymphedema presented to different lymphedema centers in Turkey.
The socio-demographic and clinical characteristics of the children including age, gender, presence of genetic syndromes, duration of edema, site and stage of lymphedema and the received therapies were determined. Parental and children education on self-management techniques were recorded.
A total of 122 children (female: 66, male: 56) with a mean age of 120.7 ± 71.2 months were included from 7 centers. Of them; 92% had primary, 8% had secondary lymphedema mostly due to infection and trauma. Lymphedema was part of a syndrome in 18% of the children. The most common site of involvement was the lower extremity, followed by upper extremity and genital involvement. Lymphedema was complicated in 17 % of children, mainly with a clinical picture of cellulitis, infection, and pain. The median duration of lymphedema was 41 (5-216) months. Although most of the children had stage 2 lymphedema, only 40% of them received treatment. The most commonly received treatment was compression therapy. No family or child was educated for self- care management before.
In conclusion, pediatric lymphedema has a comparable gender distribution and usually involves the lower extremities. Although most of the children had advanced disease, more than half of the patients did not receive any treatment indicating the unmet need for management of lymphedema. The education of patients and/or children about self-management methods were lacking. We suggest educational activities for both families of children with lymphedema and health care providers, in order to facilitate early reference to lymphedema units and to receive prompt preventive and therapeutic approaches for this suffering condition.
在儿科环境中降低淋巴水肿相关负担和残疾需要提高对淋巴水肿临床特征的认识和理解。本研究旨在评估在土耳其不同淋巴水肿中心就诊的小儿淋巴水肿患者的临床和人口统计学特征。
确定了儿童的社会人口统计学和临床特征，包括年龄、性别、是否存在遗传综合征、水肿持续时间、淋巴水肿的部位和阶段以及接受的治疗。记录了父母和儿童对自我管理技术的教育情况。
共纳入来自 7 个中心的 122 名儿童（女性 66 名，男性 56 名），平均年龄为 120.7±71.2 个月。其中，92%为原发性淋巴水肿，8%为继发性淋巴水肿，主要由感染和创伤引起。18%的儿童淋巴水肿是综合征的一部分。最常见的受累部位是下肢，其次是上肢和生殖器。17%的儿童出现淋巴水肿并发症，主要表现为蜂窝织炎、感染和疼痛。淋巴水肿的中位持续时间为 41（5-216）个月。尽管大多数儿童处于 2 期淋巴水肿，但只有 40%的儿童接受了治疗。最常见的治疗方法是压迫疗法。之前没有家庭或儿童接受过自我护理管理教育。
总之，小儿淋巴水肿的性别分布相似，通常累及下肢。尽管大多数儿童患有晚期疾病，但超过一半的患者未接受任何治疗，表明淋巴水肿管理存在未满足的需求。缺乏对患者和/或儿童进行自我管理方法的教育。我们建议对有淋巴水肿的儿童的家庭和医疗保健提供者开展教育活动，以便为他们提供便利，使其能早期向淋巴水肿单位就诊，并对这种痛苦的状况采取及时的预防和治疗措施。
