腰椎交感神经节阻滞治疗癌相关性下肢继发性淋巴水肿：一项回顾性研究。

Lumbar Sympathetic Ganglion Block for Cancer-Associated Secondary Lower Limb Lymphedema: A Retrospective Study.

机构信息

Department of Pain Medicine, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, Fujian Province, China; Pain Research Institute of Fujian Medical University, Fuzhou, Fujian Province, China.

Department of Gynecology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, Fujian Province, China.

出版信息

Pain Physician. 2022 Nov;25(8):E1269-E1277.

PMID:36375200

Abstract

BACKGROUND

Although lower limb lymphedema (LLL) is more or equally as frequent and harmful as upper limb lymphedema after cancer treatment, there are only a few studies on this topic. Cancer-related secondary LLL not only has physical implications, but also affects quality of life among patients who underwent gynecological cancer treatment. Despite numerous studies of various therapies, the optimal treatment for cancer-related LLL is still unknown.

OBJECTIVES

We aimed to investigate the efficacy of lumbar sympathetic ganglion block (LSGB) in patients with secondary LLL in the present study.

STUDY DESIGN

This study is a retrospective study.

SETTING

A single academic hospital, outpatient setting.

METHODS

A total of 30 patients with secondary unilateral LLL and failed complex decongestive treatment, from January 2017 through May 2021, were reviewed for inclusion in this study. The patients underwent fluoroscopy-guided LSGB 2 times with the help of digital subtraction angiography at 3-day intervals. Leg circumference was measured, and the volume of the leg was calculated before surgery, on the first day after the first surgery, on the first day after the second surgery, and on the seventh day after the second surgery. The World Health Organization Quality of Life Instrument Questionnaire scores were monitored before and after LSGB.

RESULTS

The leg circumference and volume decreased significantly from baseline after the treatment (P < 0.001). One week after 2 rounds of LSGB, the physical health score, psychological score, and social relationships score were higher than those before treatment (all P < 0.05). There was no difference in the environmental health score (P = 0.2731).

LIMITATIONS

This study was limited by its sample size and retrospective observational design.

CONCLUSIONS

LSGB can be a safe and effective treatment option for patients with secondary LLL after gynecological cancer treatment.

摘要

背景

尽管下肢淋巴水肿（LLL）在癌症治疗后与上肢淋巴水肿一样频繁且危害更大，但针对该主题的研究却很少。癌症相关的继发性 LLL 不仅具有身体影响，而且会影响接受妇科癌症治疗的患者的生活质量。尽管针对各种疗法进行了大量研究，但癌症相关 LLL 的最佳治疗方法仍不清楚。

目的

本研究旨在调查腰椎交感神经节阻滞（LSGB）在继发性 LLL 患者中的疗效。

研究设计

这是一项回顾性研究。

研究地点

一家学术型单医院，门诊设置。

方法

回顾性分析 2017 年 1 月至 2021 年 5 月期间，30 例继发性单侧 LLL 且复杂减压治疗失败的患者，纳入本研究。患者在数字减影血管造影术的协助下，间隔 3 天进行 2 次透视引导 LSGB。在手术前、第一次手术后第一天、第二次手术后第一天和第二次手术后第 7 天测量腿围并计算腿的体积。在 LSGB 前后监测世界卫生组织生活质量问卷评分。