Department of Surgery, Harlem Hospital Center, Columbia University, New York, NY.
Department of Surgery, Harlem Hospital Center, Columbia University, New York, NY.
Ann Vasc Surg. 2024 Nov;108:333-337. doi: 10.1016/j.avsg.2024.04.031. Epub 2024 Jul 14.
Phlebolymphedema is a challenging condition to manage, with limited options for effective treatment. For patients, this may be debilitating and lead to infection, loss of independence and affect quality of life. This study aims to evaluate patient-reported outcomes of an advanced pneumatic compression device (APCD) in the treatment of lower extremity phlebolymphedema.
Patients with diagnosis of lower extremity phlebolymphedema at an acute care facility within the New York City Health and Hospitals Cooperation treated with the Flexitouch (FLX) (Tactile Systems Technology, Inc, Minneapolis, Minnesota) APCD from December 2021 to March 2023 were evaluated. Patient-perceived subjective outcomes were assessed via a short questionnaire, with subsequent analysis using chi-squared test. Primary end points were subjective improvements in 1) swelling, 2) pain, and 3) ease of use of device as surrogates for patient satisfaction. Secondary end point was subjective patient-reported compliance, obtained by investigating 1) if patients were trained to use device, and 2) if patients were using the device.
A total of 52 participants were included in this study, consisting of 30.8% male and 69.2% female patients with a mean age of 71.7 years. While selection criteria did not exclude unilateral disease or alternative etiologies, we note that the entire study population had been diagnosed with bilateral lower extremity lymphedema in the setting of chronic venous insufficiency. Other patient characteristics including race, comorbidities and smoking status were documented in Table 1. Table 2 demonstrates the results of chi-squared analysis. This study noted significant patient-perceived improvement in swelling and pain (91.4% with P < 0.00001; 85.7% with P = 0.00002 respectively) and patient-reported ease of use of the FLX device (85.7% with P = 0.00002). Additional secondary findings included a majority of patients reporting being trained on how to use FLX and also maintaining compliance with the device (69.2% with P = 0.005; 67.3% with P = 0.012 respectively).
FLX APCD use has been found to demonstrate desirable patient-reported outcomes as a general trend. The participants in this study noted statistically significant subjective improvement in swelling and pain, ease of use of device and adherence to training and compliance with device. FLX appears to be positively received by patients, and the authors recommend its consideration for management of bilateral lower extremity phlebolymphedema.
静脉淋巴水肿的治疗具有挑战性，有效的治疗选择有限。对患者来说，这种疾病可能会导致身体虚弱，并引发感染、丧失独立性，从而影响生活质量。本研究旨在评估一种新型气动压缩装置（APCD）在治疗下肢静脉淋巴水肿方面的患者报告结局。
2021 年 12 月至 2023 年 3 月，在纽约市卫生与医院公司的一家急症护理机构中，对下肢静脉淋巴水肿确诊的患者使用 Flexitouch（FLX）（Tactile Systems Technology，Inc.，明尼苏达州明尼阿波利斯市）APCD 进行治疗。通过一个简短的问卷评估患者的主观结局，随后使用卡方检验进行分析。主要终点是 1）肿胀、2）疼痛和 3）患者对设备易用性的主观改善，作为患者满意度的替代指标。次要终点是通过调查 1）患者是否接受过设备使用培训，以及 2）患者是否正在使用设备来评估患者报告的主观依从性。
本研究共纳入 52 名参与者，其中 30.8%为男性，69.2%为女性，平均年龄为 71.7 岁。尽管入选标准并未排除单侧疾病或其他病因，但请注意，整个研究人群均被诊断为慢性静脉功能不全引起的双侧下肢淋巴水肿。表 1 中记录了其他患者特征，包括种族、合并症和吸烟状况。表 2 展示了卡方分析的结果。本研究发现，患者在肿胀和疼痛方面的主观改善显著（91.4%，P<0.00001；85.7%，P=0.00002），以及患者对 FLX 设备易用性的报告（85.7%，P=0.00002）。其他次要发现包括大多数患者报告接受了如何使用 FLX 的培训，并且坚持使用设备（69.2%，P=0.005；67.3%，P=0.012）。
FLX APCD 的使用显示出了良好的患者报告结局趋势。本研究中的参与者在肿胀、疼痛、设备易用性以及对培训和设备使用的依从性方面均有显著的主观改善。FLX 似乎受到了患者的好评，作者建议将其用于治疗双侧下肢静脉淋巴水肿。
