抗阻功能训练治疗宫颈癌盆腔淋巴结清扫术后下肢淋巴水肿效果观察

Observation on the effect of resistance training on treatment of lower limb lymphedema after pelvic lymphadenectomy for cervical cancer

目的观察抗阻功能训练在宫颈癌盆腔淋巴结清扫术后下肢淋巴水肿(lower limb lymphedema,LLL)治疗中的效果。方法选取空军军医大学第一附属医院2021年1月~2022年6月期间行根治性切除联合盆腔淋巴结清扫的110例患者,采用随机数表法分为对照组和抗阻训练组,各55例。对照组采用肝素、梯度压力袜等综合干预措施。抗阻训练组在综合预防措施基础上增加抗阻训练。以弹力带为训练工具,采用小负荷渐进式方案训练24周。患者每月复查1次,监测下肢淋巴水肿发生情况。比较两组LLL发生率、首次发生时间及下肢沉重感、疼痛、活动受限等水肿相关症状发生率。比较两组术前及干预24周后大腿周径和小腿周径。结果对照组下肢淋巴水肿发生率为30.91%(17∕55),抗阻训练组LLL发生率为11.11%(6∕54),差异有统计学意义(χ2=6.415,P=0.011)。抗阻训练组出现LLL的时间晚于对照组。抗阻训练组水肿相关症状发生率低于对照组,差异有统计学意义(P<0.05)。术前,两组大腿周径、小腿周径比较差异无统计学意义(P>0.05)。术后两组大腿周径、小腿周径均较术前增加,干预24周后两组间比较,抗阻训练组大腿、小腿周径均低于对照组,其中小腿周径差异有统计学意义(P<0.05)。结论与常规综合防治措施相比,宫颈癌盆腔淋巴结清扫术患者联合小负荷渐进式抗阻功能训练可降低下肢淋巴水肿发生风险,减轻水肿相关症状。

Objective To observe the effect of resistance function training in the treatment of lower limb lymphedema(LLL)after pelvic lymphadenectomy for cervical cancer.Methods From January 2021 to June 2022,110 patients who underwent radical resection and pelvic lymph node dissection were studied.The patients were divided into control group(55 cases)and resistance training group(55 cases)by random number table.The control group was treated with heparin and gradient pressure socks.The resistance training group increased resistance training on the basis of comprehensive preventive measures.Took elastic band as the training tool,and used small load progressive training program for 24 weeks.The patients were re-examined once a month to monitor the occurrence of lower limb lymphedema.The incidence of LLL,the time of first occurrence,and the incidence of edema related symptoms such as lower limb heaviness,pain,and limited activity were compared between the two groups.The thigh circumference and calf circumference of the two groups were compared before operation and after 24 weeks of intervention.Results The incidence of lower limb lymphedema in the control group was 30.91%(17∕55),and the incidence of LLL in the resistance training group was 11.11%(6∕54).The difference between the two groups was statistically significant(χ2=6.415,P=0.011).The time of LLL in the resistance training group was later than that in the control group.The incidence of edema related symptoms in the resistance training group was lower than that in the control group,and the difference was statistically significant(P<0.05).Before operation,there was no significant difference between the two groups in thigh circumference and calf circumference(P>0.05).After operation,the thigh circumference and leg circumference of the two groups increased compared with those before operation.After 24 weeks of intervention,the thigh circumference and leg circumference of the resistance training group were lower than those of the control group,and the leg circumference difference was statistically significant(P<0.05).Conclusion Compared with routine comprehensive preventive measures,patients with cervical cancer undergoing pelvic lymph node dissection combined with small load progressive resistance function training can reduce the risk of lower limb lymphedema and alleviate edema related symptoms.