背景:由于隔离和有限的社交活动,在封锁期间,乳腺癌患者的淋巴水肿的检测和治疗存在延迟。此外,这种情况导致了这些患者的社会心理问题。鉴于缺乏关于冠状病毒病(COVID-19)大流行期间淋巴水肿的患病率和影响的信息,我们旨在评估COVID-19大流行期间出院乳腺癌患者淋巴水肿复发的发生率及其影响因素.
方法:这是一个多中心,横截面,在COVID-19大流行期间,在武汉市的8家一流医院对出院乳腺癌患者进行了基于医院的调查,中国。使用诺曼问卷评估淋巴水肿。进行单变量和多变量二元逻辑回归分析以确定影响中度或重度淋巴水肿的因素。生活特征的差异,焦虑,在无/轻度淋巴水肿组和中度/重度淋巴水肿组之间比较抑郁。确定了大流行期间淋巴水肿管理的偏好。
结果:总体而言,202名患者被纳入本研究,其中191例报告复发性淋巴水肿(患病率:94.6%,95%置信区间[CI]90.5%至97.3%)。其中,134和57有轻度和中度/重度淋巴水肿,分别。在191名患者中,主要症状为肿胀(140;69.3%)和疼痛(56,27.7%)。多元回归显示,年龄较大(比值比[OR],1.06;95%CI:1.02-1.10),根治性手术(OR=4.35,95%CI:1.54-12.50),完全放疗(OR=2.62,95%CI:1.17-5.87,p=0.019)与中度/重度淋巴水肿的风险升高相关.中度/重度淋巴水肿组的焦虑和抑郁发生率高于无/轻度淋巴水肿组。患者同样更喜欢在医院接受治疗,并在家中进行自我护理。
结论:在COVID-19大流行期间,在患者中观察到淋巴水肿的高患病率年龄,根治性手术和完全完成放疗与严重淋巴水肿的风险增加相关。同时,严重淋巴水肿患者出现心理困扰。虽然新冠肺炎疫情仍在肆虐,应不断努力识别有淋巴水肿风险的患者,并为淋巴水肿的自我管理提供可行的指导和教育.
BACKGROUND: There has been a delay in the detection and treatment of lymphedema in breast cancer patients during the lockdown owing to quarantine and limited social activity. Moreover, this scenario has caused psychosocial issues in these patients. Given that there is scarce information on the prevalence and influence of lymphedema during the coronavirus disease (COVID-19) pandemic, we aimed to estimate the prevalence of lymphedema recurrence and its influencing factors among discharged breast cancer patients during the COVID-19 pandemic.
METHODS: This was a multicenter, cross-sectional, hospital-based survey of discharged breast cancer patients was conducted during the COVID-19 pandemic in eight first-class hospitals in Wuhan,
China. The Norman Questionnaire was used to assess lymphedema. Univariable and multivariable binary logistic regression analyses were performed to identify factors influencing moderate or severe lymphedema. Differences in living characteristics, anxiety, and depression were compared between the no/mild lymphedema group and the moderate/severe lymphedema groups. Preferences for lymphedema management during the pandemic were determined.
RESULTS: Overall, 202 patients were included in this study, and 191 of them reported recurrent lymphedema (prevalence: 94.6%, 95% confidence interval [CI] 90.5% to 97.3%). Among them, 134 and 57 had mild and moderate/severe lymphedema, respectively. In 191 patients, the main symptoms were swelling (140; 69.3%) and pain (56, 27.7%). Multivariable regression showed that older age (odds ratio [OR], 1.06; 95% CI: 1.02-1.10), radical surgery (OR = 4.35, 95% CI: 1.54-12.50), and fully complete radiotherapy (OR = 2.62, 95% CI: 1.17-5.87, p = 0.019) were associated with an elevated risk of moderate/severe lymphedema. The moderate/severe lymphedema group experienced a higher rate of anxiety and depression than the no/mild lymphedema group did. Patients equally preferred treatment in the hospital and self-care at home.
CONCLUSIONS: During the COVID-19 pandemic, high prevalence of lymphedema was observed in patients Age, radical surgery and fully completed radiotherapy were associated with increased risk of severer lymphedema. Meanwhile, the patients with severe lymphedema experienced psychological distress. While the Covid-19 pandemic was still raging, continuous efforts should be made to identify patient at risk of lymphedema and distribute feasible guidance and education for self-management in lymphedema.