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淋巴管静脉吻合术对淋巴水肿患者生活质量、身体形象和精神健康的影响:一项前瞻性队列研究。

Effects of Lymphaticovenous Anastomosis on Quality of Life, Body Image, and Spiritual Health in Lymphedema Patients: A Prospective Cohort Study.

作者信息

Peng Shu-Hui, Huang Ching-Ya, Shih Chun-Ming, Tsai Pei-Yu, Yang Johnson Chia-Shen, Hsieh Ching-Hua

机构信息

Department of Plastic Surgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan.

Graduate School of Human Sexuality, Shu-Te University, Kaohsiung 824445, Taiwan.

出版信息

Healthcare (Basel). 2024 Jul 16;12(14):1419. doi: 10.3390/healthcare12141419.

Abstract

BACKGROUND

Lymphedema is a debilitating condition that significantly affects quality of life due to its chronic nature and visible symptoms. Lymphaticovenous anastomosis (LVA) has emerged as a promising surgical intervention, yet its effects on body image and spiritual health alongside physical symptoms have not been thoroughly examined. This study evaluates the efficacy of LVA in improving symptoms, quality of life (QOL), body image, and spiritual well-being in lymphedema patients.

METHODS

A prospective cohort study was conducted at Kaohsiung Chang Gung Memorial Hospital, Taiwan, involving 44 patients with lymphedema undergoing LVA surgery. Evaluations were made pre-surgery, one month post-surgery, and six months post-surgery using the 36-Item Short Form Health Survey (SF-36), Multidimensional Body-Self Relations Questionnaire-Appearance Scales (MBSRQ-AS), and a spiritual health scale. Statistical analysis was performed using one-way repeated measures ANOVA.

RESULTS

Significant improvements were observed in lymphedema symptoms and QOL measures at six months post-operation. SF-36 results showed enhanced scores in nearly all domains, particularly in physical functioning and role-physical. The appearance orientation scores from the MBSRQ-AS significantly increased, indicating improved perceptions in some dimensions of body image.

CONCLUSIONS

LVA surgery significantly enhances physical and psychological outcomes in patients with lymphedema, with marked improvements in symptoms, QOL, and body image perceptions. The findings suggest that while LVA is effective in addressing the physical and psychological aspects of lymphedema, it does not impact spiritual dimensions. This underscores the need for holistic approaches in the management of lymphedema to address all facets of patient well-being.

摘要

背景

淋巴水肿是一种使人衰弱的病症,因其慢性性质和明显症状而严重影响生活质量。淋巴静脉吻合术(LVA)已成为一种有前景的外科干预手段,但其对身体形象和精神健康以及身体症状的影响尚未得到充分研究。本研究评估LVA在改善淋巴水肿患者症状、生活质量(QOL)、身体形象和精神幸福感方面的疗效。

方法

在台湾高雄长庚纪念医院进行了一项前瞻性队列研究,纳入44例接受LVA手术的淋巴水肿患者。在术前、术后1个月和术后6个月使用36项简短健康调查(SF - 36)、多维身体自我关系问卷 - 外貌量表(MBSRQ - AS)和精神健康量表进行评估。使用单向重复测量方差分析进行统计分析。

结果

术后6个月,淋巴水肿症状和生活质量指标有显著改善。SF - 36结果显示几乎所有领域的得分都有所提高,尤其是在身体功能和身体角色方面。MBSRQ - AS的外貌取向得分显著增加,表明在身体形象的某些维度上认知有所改善。

结论

LVA手术显著改善了淋巴水肿患者的身体和心理状况,症状、生活质量和身体形象认知都有明显改善。研究结果表明,虽然LVA在解决淋巴水肿的身体和心理方面有效,但对精神维度没有影响。这强调了在淋巴水肿管理中需要采用整体方法来解决患者福祉的所有方面。

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