摘要
目的 探讨规范化综合消肿治疗(CDT)对亚临床期下肢淋巴水肿的疗效.方法 选取2021年6月至2022年12月于西安交通大学附属西安市中心医院烧伤整形美容外科门诊就诊的23例亚临床期下肢淋巴水肿患者作为研究对象,行规范化CDT治疗并随访12个月.采用下肢淋巴水肿指数(LELI)评估患肢肿胀严重程度,采用下肢淋巴水肿功能、残疾与健康问卷(Lymph-ICF-LL)评估患者主观肢体症状和心理症状改善情况,对患者主观肢体症状与LELI之间的相关性进行Spearman相关分析.结果 治疗前及治疗后6、12个月,患者LELI分别为229.94±13.22、213.13±16.68和 207.60±15.51,差异有统计学意义(F=58.316,P=0.001),表明规范化CDT治疗后患肢体积逐渐减小.治疗前及治疗后6、12个月,患者Lymph-ICF-LL肢体症状得分分别为(23.12±6.16)分、(17.43±7.39)分和(14.30±8.42)分,差异有统计学意义(F=20.026,P=0.001),表明规范化CDT治疗后患者肢体症状减轻;Lymph-ICF-LL心理症状得分分别为(18.83±10.51)分、(17.09±10.66)分和(14.57±7.48)分,差异无统计学意义(F=2.315,P=0.136),表明规范化CDT治疗后患者心理症状改善不明显.患者主观肢体症状中紧绷感与LELI之间呈中度正相关(r=0.522,P=0.011);麻木感与LELI之间呈低度正相关(r=0.447,P=0.032);肿胀感、沉重感、疼痛感与LELI之间不存在相关性(r=0.202、0.374、0.255,P=0.356、0.079、0.240).结论 规范化CDT作为一种将干预措施和生活方式改变相结合的淋巴水肿保守治疗方法,可缓解患肢肿胀,减轻肢体症状,值得进一步推广.
Abstract
Objective To investigate the efficacy of standardized complete decongestive therapy(CDT)in subclinical lower extremity lymphedema.Methods From June 2021 to December 2022,23 patients with subclinical lower extremity lymphedema treated in the Department of Burn,Plastic and Cosmetic Surgery,Xi'an Central Hospital,Xi'an Jiaotong University were selected as the research objects,and the patients were treated with standardized CDT and followed up for 12 months.The lower extremity lymphedema index(LELI)was used to evaluate the severity of limb swelling,and lymphedema functioning,disability and health questionnaire for lower limb lymphedema(Lymph-ICF-LL)was used to evaluate the improvement of subjective limb symptoms and psychological symptoms.Spearman correlation analysis was used to analyse the correlation between subjective limb symptoms and LELI.Results The LELI of patients before treatment and 6,12 months after treatment was 229.94±13.22,213.13±16.68 and 207.60±15.51,respectively,the difference was statistically significant(F=58.316,P=0.001),indicating that the lower limb volume gradually decreased after standardized CDT treatment.The limb symptom score of Lymph-ICF-LL before treatment and 6,12 months after treatment was 23.12±6.16,17.43±7.39 and 14.30±8.42,respectively,with statistically significant difference(F=20.026,P=0.001),indicating that the limb symptoms of patients were alleviated after standardized CDT treatment.The psychological symptom score of Lymph-ICF-LL before treatment and 6,12 months after treatment was 18.83±10.51,17.09±10.66 and 14.57±7.48,respectively,the difference was not statistically significant(F=2.315,P=0.136),indicating that the psychological symptoms of patients after standardized CDT treatment were not significantly improved.There was a moderate positive correlation between tension and LELI(r=0.522,P=0.011),and a low positive correlation between numbness and LELI(r=0.447,P=0.032).There was no correlation between swelling,heaviness,pain and LELI(r=0.202,0.374,0.255;P=0.356,0.079,0.240).Conclusion As a conservative treatment for lymphedema combining intervention measures and lifestyle changes,standardized CDT can alleviate limb swelling and relieve limb symptoms,which is worthy of further promotion.
维普
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