目的:系统评价徒手淋巴引流(Manual Lymph Drainage,MLD)预防和治疗乳腺癌相关淋巴水肿(Breast Cancer Related Lymphedema,BCRL)的效果,为合理制定BCRL预防和治疗方案提供证据。方法:检索PubMed、EMBASE、The Cochrane Library.中国生...目的:系统评价徒手淋巴引流(Manual Lymph Drainage,MLD)预防和治疗乳腺癌相关淋巴水肿(Breast Cancer Related Lymphedema,BCRL)的效果,为合理制定BCRL预防和治疗方案提供证据。方法:检索PubMed、EMBASE、The Cochrane Library.中国生物医学文献数据库(CMB)、中国知网(CNKI),全面收集MLD预防和治疗BCRL的随机对照试验(RCT),检索年限为建库至2018年3月;由2名评价者按照研究的纳入、排除标准筛选文献并独立评价文献质量,采用RevMan5.3软件进行Meta分析。结果:共纳入9个RCT,1 112例患者;Meta分析结果显示,MLD预防BCRL发生的效果与其他措施相比差异有统计学意义[OR=0.31,95%CI(0.12,0.83),Z=2.33,P=0.02];MLD治疗BCRL的效果与其他措施相比差异无统计学意义[SMD=0.17,95%CI(0.08,0.41),Z=1.34,P=0.1S][WMD=-0.219 95%CI(1.54,1.12),2=0.31,P=0.76];MLD预防BCRL发生的结局指标证据强度为中级,MLD治疗BCRL的2个结局指标的证据强度分别为中级、低级。结论:现有证据表明与其他护理方法相比,MLD可以有效预防BCRL的发生,但不能有效治疗BCRL患者患肢肿胀,对患肢的疼痛缓解效果也不佳;临床护理人员应在乳腺癌术后早期指导患者进行MLD,应用综合护理措施管理乳腺癌术后患者,以改善其健康结局,提高其生活质量。展开更多
目的:评价徒手淋巴引流在乳腺癌患者术后淋巴水肿中的应用效果。方法:计算机检索Cochrane Library、PubMed、Web of Science、EMBASE、中国生物医学文献数据库、中国知网、万方和维普等国内外数据库中有关徒手淋巴引流应用于乳腺癌患者...目的:评价徒手淋巴引流在乳腺癌患者术后淋巴水肿中的应用效果。方法:计算机检索Cochrane Library、PubMed、Web of Science、EMBASE、中国生物医学文献数据库、中国知网、万方和维普等国内外数据库中有关徒手淋巴引流应用于乳腺癌患者术后淋巴水肿的随机对照试验。经筛选文献,提取资料与评价文献质量后,采用RevMan 5.3软件进行Meta分析。结果:最终纳入11篇随机对照试验,共2524例患者。Meta分析结果显示,徒手淋巴引流可有效预防乳腺癌患者在术后12个月、6个月、3个月发生淋巴水肿[RR=0.35,95%CI(0.17,0.74),P<0.01;RR=0.45,95%CI(0.30,0.68),P<0.01;RR=0.24,95%CI(0.12,0.48),P<0.01],可有效减少乳腺癌患者术后淋巴水肿体积[WMD=-52.35,95%CI(-70.51,-34.19),P<0.01],可有效降低患者术后发生腋窝综合征的风险[RR=0.17,95%CI(0.09,0.34),P<0.01]。结论:徒手淋巴引流能有效预防和治疗乳腺癌患者术后淋巴水肿,以及有效预防腋窝综合征的发生,建议临床推广应用。展开更多
Objective To evaluate the therapeutic efficacy of complex decongestive therapy in the treatment of elephantiasis of the lower extremities.Methods Seventeen patients with unilateral lower limb elephantiasis were includ...Objective To evaluate the therapeutic efficacy of complex decongestive therapy in the treatment of elephantiasis of the lower extremities.Methods Seventeen patients with unilateral lower limb elephantiasis were included in the study(5 with primary lymphedema and 12 with secondary lymphedema).All patients were treated with one course(4 weeks)of complex decongestive therapy.Changes inextracellular fluid(ECF),BMI,circumferences,and skin properties including skin stiffness(SF),percent water content(PWC),and trans-epidermal water loss(TEWL)were measured before and after treatment.Results The“elephantiasis-like”appearance of the affected limb was greatly improved after treatment.The ECF,BMI,and circumferences were significantly decreased after treatment(P<0.001)with an average ECF of 2.97±1.82 L,BMI of 1.638±2.647 kg/m^2,and circumference of 6.58±2.79 cm.The values of PWC,TEWL,and SFwere 50.5%±10.6%,18.55±10.2 g/m^2 h,and 0.161±0.176 N,respectively,before treatment and 36.05%±7%,8.3±2.07 g/m^2h,and 0.086±0.038 N,respectively,after treatment,there by showing significant decreases(P<0.05).Conclusion Complex decongestive therapy is effective in the treatment of advanced stages of chronic lymphedema.展开更多
文摘目的:系统评价徒手淋巴引流(Manual Lymph Drainage,MLD)预防和治疗乳腺癌相关淋巴水肿(Breast Cancer Related Lymphedema,BCRL)的效果,为合理制定BCRL预防和治疗方案提供证据。方法:检索PubMed、EMBASE、The Cochrane Library.中国生物医学文献数据库(CMB)、中国知网(CNKI),全面收集MLD预防和治疗BCRL的随机对照试验(RCT),检索年限为建库至2018年3月;由2名评价者按照研究的纳入、排除标准筛选文献并独立评价文献质量,采用RevMan5.3软件进行Meta分析。结果:共纳入9个RCT,1 112例患者;Meta分析结果显示,MLD预防BCRL发生的效果与其他措施相比差异有统计学意义[OR=0.31,95%CI(0.12,0.83),Z=2.33,P=0.02];MLD治疗BCRL的效果与其他措施相比差异无统计学意义[SMD=0.17,95%CI(0.08,0.41),Z=1.34,P=0.1S][WMD=-0.219 95%CI(1.54,1.12),2=0.31,P=0.76];MLD预防BCRL发生的结局指标证据强度为中级,MLD治疗BCRL的2个结局指标的证据强度分别为中级、低级。结论:现有证据表明与其他护理方法相比,MLD可以有效预防BCRL的发生,但不能有效治疗BCRL患者患肢肿胀,对患肢的疼痛缓解效果也不佳;临床护理人员应在乳腺癌术后早期指导患者进行MLD,应用综合护理措施管理乳腺癌术后患者,以改善其健康结局,提高其生活质量。
文摘目的:评价徒手淋巴引流在乳腺癌患者术后淋巴水肿中的应用效果。方法:计算机检索Cochrane Library、PubMed、Web of Science、EMBASE、中国生物医学文献数据库、中国知网、万方和维普等国内外数据库中有关徒手淋巴引流应用于乳腺癌患者术后淋巴水肿的随机对照试验。经筛选文献,提取资料与评价文献质量后,采用RevMan 5.3软件进行Meta分析。结果:最终纳入11篇随机对照试验,共2524例患者。Meta分析结果显示,徒手淋巴引流可有效预防乳腺癌患者在术后12个月、6个月、3个月发生淋巴水肿[RR=0.35,95%CI(0.17,0.74),P<0.01;RR=0.45,95%CI(0.30,0.68),P<0.01;RR=0.24,95%CI(0.12,0.48),P<0.01],可有效减少乳腺癌患者术后淋巴水肿体积[WMD=-52.35,95%CI(-70.51,-34.19),P<0.01],可有效降低患者术后发生腋窝综合征的风险[RR=0.17,95%CI(0.09,0.34),P<0.01]。结论:徒手淋巴引流能有效预防和治疗乳腺癌患者术后淋巴水肿,以及有效预防腋窝综合征的发生,建议临床推广应用。
文摘Objective To evaluate the therapeutic efficacy of complex decongestive therapy in the treatment of elephantiasis of the lower extremities.Methods Seventeen patients with unilateral lower limb elephantiasis were included in the study(5 with primary lymphedema and 12 with secondary lymphedema).All patients were treated with one course(4 weeks)of complex decongestive therapy.Changes inextracellular fluid(ECF),BMI,circumferences,and skin properties including skin stiffness(SF),percent water content(PWC),and trans-epidermal water loss(TEWL)were measured before and after treatment.Results The“elephantiasis-like”appearance of the affected limb was greatly improved after treatment.The ECF,BMI,and circumferences were significantly decreased after treatment(P<0.001)with an average ECF of 2.97±1.82 L,BMI of 1.638±2.647 kg/m^2,and circumference of 6.58±2.79 cm.The values of PWC,TEWL,and SFwere 50.5%±10.6%,18.55±10.2 g/m^2 h,and 0.161±0.176 N,respectively,before treatment and 36.05%±7%,8.3±2.07 g/m^2h,and 0.086±0.038 N,respectively,after treatment,there by showing significant decreases(P<0.05).Conclusion Complex decongestive therapy is effective in the treatment of advanced stages of chronic lymphedema.
