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脂肪性水肿抽脂术后健康相关生活质量及症状的改善:一项纵向研究

Improvement in Health-Related Quality of Life and Symptoms Following Lipedema Liposuction: A Longitudinal Study.

作者信息

Karri Vasu

机构信息

From The Karri Clinic, Willerby, East Riding of Yorkshire, England.

出版信息

Ann Plast Surg. 2025 Jan 1;94(1):e1-e10. doi: 10.1097/SAP.0000000000004124. Epub 2024 Oct 25.

Abstract

BACKGROUND

Lipedema is a chronic fat disorder characterized by disproportionate fat deposition in the lower limbs, leading to pain, mobility issues and reduced health related quality of life (HRQoL).There is growing evidence that liposuction of the excess fat not only reduces soft tissue pain but also improves HRQoL. The published data, however, remain limited, and there are no studies of liposuction in the UK lipedema population. This study aimed to evaluate the effectiveness of liposuction on HRQoL and symptoms in UK lipedema patients using 2 HRQoL instruments and a Lipedema Symptom Scale.

PATIENT AND METHODS

Lipedema patients undergoing liposuction between January 2016 and December 2021 completed Short-Form Health Survey (SF-36), World Health Organization Quality-of-Life Assessment (WHOQOL-BREF), and 17-question Lipedema Symptom Scale preoperatively and postoperatively. Paired t test was used to compare the preoperative and postoperative mean scores of the different domains of the SF-36 and WHOQOL-BREF and preoperative and postoperative mean scores for the lipedema symptom scale. Paired t test was also used to compare preoperative and postoperative SF-36 scores to age-matched normative data for the English population to assess the extent of HRQoL improvement relative to the general population.

RESULTS

Seventy-six women were included in the study with a mean age of 46.4 ± 12 years. Mean follow-up (interval between first liposuction surgery and postoperative completion of the instruments) was 25.3 ± 23.2 months. There was significant improvement in all SF-36 and WHOQOL-BREF domains postoperatively ( P < 0.001). Compared with age-matched normative data, postoperative SF-36 scores remained lower in physical functioning, social functioning, and general health. Postoperative results also showed a highly significant improvement ( P < 0.001) across all 17 items of the Lipedema Symptom Scale.

CONCLUSION

This longitudinal study indicates liposuction is an effective treatment for improving HRQoL and symptoms in lipedema patients, although it may not completely restore HRQoL to normative levels. Limitations include potential selection bias, sampling bias, and the need for longer follow-up. The findings support liposuction as a first-line treatment for lipedema and could inform decision-making for both patients and policymakers.

摘要

背景

脂肪性水肿是一种慢性脂肪代谢紊乱疾病,其特征是下肢脂肪沉积不成比例,导致疼痛、行动不便以及健康相关生活质量(HRQoL)下降。越来越多的证据表明,抽脂去除多余脂肪不仅能减轻软组织疼痛,还能改善健康相关生活质量。然而,已发表的数据仍然有限,且尚无针对英国脂肪性水肿人群抽脂手术的研究。本研究旨在使用两种健康相关生活质量评估工具和脂肪性水肿症状量表,评估抽脂手术对英国脂肪性水肿患者健康相关生活质量和症状的疗效。

患者与方法

2016年1月至2021年12月期间接受抽脂手术的脂肪性水肿患者在术前和术后完成了简明健康调查问卷(SF-36)、世界卫生组织生活质量评估量表(WHOQOL-BREF)以及17项脂肪性水肿症状量表的填写。采用配对t检验比较SF-36和WHOQOL-BREF不同领域的术前和术后平均得分,以及脂肪性水肿症状量表的术前和术后平均得分。还使用配对t检验将术前和术后的SF-36得分与英国人群年龄匹配的标准数据进行比较,以评估相对于一般人群健康相关生活质量改善的程度。

结果

76名女性纳入本研究,平均年龄为46.4±12岁。平均随访时间(首次抽脂手术与术后完成评估工具之间的间隔)为25.3±23.2个月。术后所有SF-36和WHOQOL-BREF领域均有显著改善(P<0.001)。与年龄匹配的标准数据相比,术后SF-36在身体功能、社会功能和总体健康方面的得分仍然较低。术后结果还显示,脂肪性水肿症状量表的所有17项在术后均有高度显著改善(P<0.001)。

结论

这项纵向研究表明,抽脂手术是改善脂肪性水肿患者健康相关生活质量和症状的有效治疗方法,尽管它可能无法将健康相关生活质量完全恢复到正常水平。局限性包括潜在的选择偏倚、抽样偏倚以及需要更长时间的随访。研究结果支持将抽脂手术作为脂肪性水肿的一线治疗方法,并可为患者和政策制定者的决策提供参考。

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