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干热处理(流体疗法)在乳腺癌相关淋巴水肿管理中的短期效果:一项随机对照研究。

Short-Term Effects Of Dry Heat Treatment (Fluidotherapy) In The Management Of Breast Cancer Related Lymphedema: A Randomized Controlled Study.

机构信息

University of Health Sciences Ankara Training and Research Hospital Department of Physical Medicine and Rehabilitation, Division of Oncology and Lymphedema Rehabilitation, Ankara, Turkey.

Ankara Private Koru Hospital, Department of Physical Medicine and Rehabilitation, Ankara, Turkey.

出版信息

Clin Breast Cancer. 2024 Jul;24(5):439-446. doi: 10.1016/j.clbc.2024.02.019. Epub 2024 Mar 1.

Abstract

BACKGROUND

To investigate whether fluidotherapy added to complete decongestive therapy (CDT) would provide additional contribution to edema reduction in patients with breast cancer related lymphedema (BCRL).

MATERIAL AND METHODS

Thirthy-two patients with unilateral BCRL were randomly divided into 2 groups: standard treatment with CDT only (Group 1) and CDT + fluidotherapy (Group 2). All patients underwent phase 1 CDT, which included manual lymphatic drainage, multilayer bandaging, supervised exercises and skin care for a total of 15 sessions, 5 times a week for 3 weeks. Only Group 2 received a total of 15 sessions application of fluidotherapy. Before and after CDT, patients were evaluated for extremity volumes and excess volumes, according to circumferencial measurements of the extremity. Arm pain was evaluated with Visual Analaogue Scale (VAS-Pain).

RESULTS

Seventeen patients in Group 1 and 15 patients in Group 2 completed the study. Patients' demographic data and volume measurements were similar at the beginning of the treatment. Limb volumes of both groups were significantly reduced after treatment (P < .001 for both group). Pain significantly decreased (P = .001 for both group). No adverse reactions were recorded. The mean change in volume measurements and VAS-Pain scores of patients in CDT+fluidotherapy group before and after treatment were significantly higher than those in only CDT group (P = .028, P = .020 respectively).

CONCLUSION

Fluidotherapy added to CDT reduced pain and edema severity more than standard CDT in the patients with BCRL. As a noninvasive, novel, and effective method, fluidotherapy may be a promising treatment modality for the treatment of lymphedema.

摘要

背景

为了研究在完全消肿疗法(CDT)中加入流体疗法是否会对乳腺癌相关淋巴水肿(BCRL)患者的消肿有额外贡献。

材料和方法

32 名单侧 BCRL 患者被随机分为 2 组:仅接受 CDT 标准治疗(组 1)和 CDT+流体疗法(组 2)。所有患者均接受了 1 期 CDT,包括手动淋巴引流、多层包扎、监督锻炼和皮肤护理,共 15 次,每周 5 次,持续 3 周。仅组 2 接受了总共 15 次的流体疗法应用。在 CDT 前后,根据肢体的周径测量值,评估肢体体积和多余体积。手臂疼痛采用视觉模拟量表(VAS-Pain)进行评估。

结果

组 1 中有 17 名患者和组 2 中有 15 名患者完成了研究。治疗开始时,患者的人口统计学数据和体积测量值相似。两组的肢体体积在治疗后均显著减少(两组均 P<0.001)。疼痛明显减轻(两组均 P=0.001)。未记录到不良反应。与仅接受 CDT 的组相比,接受 CDT+流体疗法的组在治疗前后的体积测量值和 VAS-Pain 评分的平均变化明显更高(P=0.028,P=0.020)。

结论

与标准 CDT 相比,在 BCRL 患者中,CDT 加流体疗法可降低疼痛和水肿的严重程度。作为一种非侵入性、新颖且有效的方法,流体疗法可能是治疗淋巴水肿的一种有前途的治疗方式。

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