空气波压力治疗仪在预防及治疗乳腺癌术后淋巴水肿效果Meta分析

Effect of intermittent pneumatic compression in the prevention and treatment of breast cancer-related lymphedema:A Meta-analysis

目的目前乳腺癌术后淋巴水肿(breast cancer-related lymphedema,BCRL)是乳腺癌患者术后最严重的并发症之一,一旦发生难以治愈,其预防和治疗也备受关注。本研究应用Meta分析,系统评价空气波压力治疗仪(intermittent pneumatic compression,IPC)在预防及治疗BCRL的应用效果。方法检索纳入从建库至2016-08-31中国期刊网全文数据库(中国知网)、维普信息资源系统、万方数据库资源系统和中国生物医学文献数据库等中文数据库;"Cochrane library、PubMed、EMbase、Joanna Briggs Institue Library、Elsevier ScienceDirect、Springer Link、RNAO"等英文数据库,关于IPC在预防和治疗BCRL的随机对照实验,按照纳入与排除标准进行文献筛选和质量评价,采用RevMan 5.3软件进行Meta分析。结果共纳入文献15篇,其中IPC用于预防的6篇、用于治疗的9篇,共1 043例患者,其中IPC组523例,对照组520例。在预防方面Meta分析结果显示,IPC组与对照组相比,乳腺癌术后患者其BCRL的发生率更低,差异有统计学意义,P<0.000 01,RR=0.31,95%CI为0.20~0.50;但在治疗方面Meta分析结果显示,IPC组与对照组相比,其在降低BCRL患肢体积上差异无统计学意义,P=0.44,MD=4.51,95%CI为7.01~16.03。结论 IPC能够有效预防BCRL的发生,但在治疗BCRL的效果、降低患肢体积上仍需进一步研究。

OBJECTIVE Breast cancer-related lymphedema（BCRL）was one of the serious complications in postoperative breast cancer patients,which couldn＇t be cured.the prevention and treatment of BCRL have became more and more important.This study is to systematically assess the efficiency of intermittent pneumatic Compression（IPC）in the prevention and treatment of breast cancer-recated lymphedema.METHODS Chinese database such as CNKI,VIP,Wan Fang,Cochrane library,Pubmed,EMbase,Joanna Briggs Institue Library,Elsevier ScienceDirect,Springer Link,RNAO and so on,randomized controlled trials in Chinese or English were retrieved and included.The time of literatures were collected from inception to August 31,2016,Handbook Cochrane（5.0.1）was used to evaluate the quality of the literature,the efficiency of IPC was determined by Meta-analysis with RevMan 5.3,the other studies were carried out by a descriptive analysis.RESULTS Totally of 15 studies were finally recruited,6for the prevention and 9for the trea tment of the IPC.The total sample size of studies was 1 043.Amomg the them,523 cases were in IPC and 520 were subjected to control group.Meta-analysis results show that,the use of IPC could effectively reduce the incidence of BCRL compared with conventional nursing methods.P〈0.000 01,（RR=0.31,95%CI：0.20-0.50）,But Meta-analysis results of the treatment showed that,there was no significant difference between the control group and the use of IPC in the treatment of lymphedema P=0.44,（MD=4.51,95%CI：7.01-16.03）.CONCLUSIONS The application of IPC in patients with breast cancer after operation could effectively prevent the occurrence of lymphedema,but the effect of the treatment of lymphedema was still needed to be further studied.