两种压力材料在乳腺癌术后上肢淋巴水肿综合消肿疗法中的效果对比研究

A comparative study on the effect of two kinds of pressure materials in complex decongestive therapy of upper limb lymphedema after breast cancer treatment

目的探讨两种不同的压力材料在乳腺癌相关性上肢淋巴水肿(BCRL)患者综合消肿疗法(CDT)压力治疗中的应用效果。方法选取2018年8月-2019年12月在淋巴水肿门诊接受CDT治疗的乳腺癌患者50例,随机分为试验组、对照组,各25例。2组在压力治疗期间分别采用2种不同材料的衬垫。对照组采用中低密度的平层敷料作为衬垫包裹肢体,试验组使用高密度泡沫制作成的大颗粒绷带作为衬垫包裹肢体。对比2组治疗前后各段肢体臂围差,比较2组患者上肢功能评定量表(DASH)值、皮肤损伤发生率。结果除虎口部位外,试验组上肢其余部位治疗前后的患肢臂围差均大于对照组(P<0.05)。治疗后,2组DASH值均较治疗前下降,且试验组DASH值低于对照组(P<0.05)。治疗期间,试验组发生皮肤损伤2(8.00%)例,对照组发生皮肤损伤9(36.00%)例,2组差异有统计学意义(χ^2=4.196,P=0.04)。结论在压力治疗期间选择高密度泡沫制作成的大颗粒绷带包裹肢体更适合临床使用。

Objective investigate the effect of two kinds of pressure materials in complex decongestive therapy(CDT)of breast cancer-related lymphedema(BCRL)after breast cancer treatment.Methods Totally 50 patients undergoing CDT for BCRL after breast cancer treatment were randomly divided into the study group and the control group,with 25 cases in each group.Both groups were treated with CDT,and two different kinds of foam were used during gradient compression bandaging therapy.The control group used a medium density foam bandage to wrap the limbs,and the study group used the adhesive webbing made of high density foam to wrap the limbs.The primary outcome was assessed by limb circumference.The Disabilities Arm Shoulder and Hand(DASH)questionnaire was introduced to facilitate assessment of upper limb function.The incidence of skin injury was compared between two groups.Results Except of the limb circumference at the part of the hand between the thumb and the index finger,the difference in limb circumference before and after treatment in the study group was larger than that of the control group(P<0.05).The DASH value in the study group was lower than that in the control group(P<0.05).There were 2(8.00%)cases of skin injury in the study group and 9(36.00%)cases of skin injury in the control group(χ^2=4.196,P=0.04).Conclusion The use of adhesive webbing made of high density foam to wrap the limbs is more suitable for gradient compression bandaging in CDT of BCRL.