Hou Shengqun, Li Yun, Lu Weiwu, Zhang Xiaoju, Luo Huiyu, Qiu Jiajia, Lu Zhenqi
Department of Nursing, Fudan University Shanghai Cancer Center, Shanghai, China.
Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.
Gland Surg. 2024 Aug 31;13(8):1358-1369. doi: 10.21037/gs-24-123. Epub 2024 Aug 28.
Complete decongestive therapy (CDT) and intermittent pneumatic compression (IPC) are the most common combination of treatments in breast cancer-related upper limb lymphedema. The effects of IPC as an addition to CDT are inconsistent in different studies. This meta-analysis aimed to explore whether IPC could bring additional benefits to CDT.
Literatures were retrieved from databases with full-text publications ranging from January 1995 to March 2024. Fixed-effect models were applied to subsequent analysis if no heterogeneity was detected by using the Inverse formula. Publication bias was assessed using the Begg's test and Eagger's test.
Twelve studies were finally included for further analysis. Results showed that additional application of IPC to CDT could further improve lymphedema within 4 weeks after the treatment period [standard mean difference (SMD) =-0.2 mL, 95% confidence interval (CI): -0.33 to -0.07 mL]. However, this additional benefit was weakened within about 9.4±2.6 weeks' follow-up duration after ceasing physical therapy (SMD =-0.15 mL, 95% CI: -0.33 to 0.04 mL).
Periodically continuous treatment should be suggested to maintain the effect of CDT + IPC to promote lymph drainage and lymphedema improvement. Nonetheless, the treatment involved in the studies ranged from 4 to 12 weeks, therefore potential bias might exist.
完全消肿疗法（CDT）和间歇性气动压迫（IPC）是乳腺癌相关上肢淋巴水肿最常见的联合治疗方法。在不同研究中，IPC作为CDT辅助治疗的效果并不一致。本荟萃分析旨在探讨IPC是否能给CDT带来额外益处。
从1995年1月至2024年3月有全文发表的数据库中检索文献。若使用逆方差公式未检测到异质性，则应用固定效应模型进行后续分析。采用Begg检验和Egger检验评估发表偏倚。
最终纳入12项研究进行进一步分析。结果显示，在治疗期后4周内，CDT联合应用IPC可进一步改善淋巴水肿[标准均差（SMD）=-0.2 mL，95%置信区间（CI）：-0.33至-0.07 mL]。然而，在停止物理治疗后的约9.4±2.6周随访期内，这种额外益处减弱（SMD =-0.15 mL，95% CI：-0.33至0.04 mL）。
应建议进行定期持续治疗，以维持CDT + IPC的效果，促进淋巴引流和淋巴水肿改善。尽管如此，研究中的治疗时间为4至12周，因此可能存在潜在偏倚。
