目的:静脉血栓形成是一种具有挑战性的疾病,有效治疗的选择有限。对于患者来说,这可能使人衰弱并导致感染,丧失独立性并影响生活质量(QOL)。这项研究旨在评估患者报告的一种先进的气动压缩装置(APCD)治疗下肢静脉水肿的结果。
方法:在纽约市卫生和医院合作机构的急性护理机构中诊断为下肢静脉水肿的患者(FLX;触觉系统技术,Inc,明尼阿波利斯,明尼苏达州)APCD从2021年12月至2023年3月进行了评估。患者感知的主观结果通过简短的问卷进行评估,随后使用卡方检验进行分析。主要终点是1)肿胀的主观改善,2)疼痛,和3)作为患者满意度的替代设备的易用性。次要终点是患者报告的主观依从性,通过调查1)患者是否接受过使用设备的培训,和2)如果患者正在使用该设备。
结果:本研究共纳入52名参与者,由30.8%的男性和69.2%的女性患者组成,平均年龄为71.7岁。虽然选择标准不排除单侧疾病或替代病因,我们注意到,在慢性静脉功能不全的情况下,整个研究人群均被诊断为双侧下肢淋巴水肿.其他患者特征,包括种族,合并症和吸烟状况见表1.表2显示了卡方分析的结果。该研究注意到患者感觉到的肿胀和疼痛有了显著改善(91.4%,P<0.00001;85.7%,P=0.00002),以及患者报告的FLX装置的易用性(85.7%,P=0.00002)。其他次要发现包括大多数患者接受了如何使用FLX的培训,并保持了对设备的依从性(分别为69.2%,P=0.005;67.3%,P=0.012)。
结论:已发现使用FLXAPCD证明患者报告的理想结局是一种普遍趋势。这项研究的参与者注意到肿胀和疼痛的主观改善具有统计学意义,易于使用的设备以及坚持培训和遵守设备。FLX似乎被患者积极接受,作者建议考虑治疗双侧下肢静脉性水肿。
BACKGROUND: Phlebolymphedema is a challenging condition to manage, with limited options for effective treatment. For patients, this may be debilitating and lead to infection, loss of independence and affect quality of life. This study aims to evaluate patient-reported outcomes of an advanced pneumatic compression device (APCD) in the treatment of lower extremity phlebolymphedema.
METHODS: Patients with diagnosis of lower extremity phlebolymphedema at an acute care facility within the New York City Health and Hospitals Cooperation treated with the Flexitouch (FLX) (Tactile Systems Technology, Inc, Minneapolis, Minnesota) APCD from December 2021 to March 2023 were evaluated. Patient-perceived subjective outcomes were assessed via a short questionnaire, with subsequent analysis using chi-squared test. Primary end points were subjective improvements in 1) swelling, 2) pain, and 3) ease of use of device as surrogates for patient satisfaction. Secondary end point was subjective patient-reported compliance, obtained by investigating 1) if patients were trained to use device, and 2) if patients were using the device.
RESULTS: A total of 52 participants were included in this study, consisting of 30.8% male and 69.2% female patients with a mean age of 71.7 years. While selection criteria did not exclude unilateral disease or alternative etiologies, we note that the entire study population had been diagnosed with bilateral lower extremity lymphedema in the setting of chronic venous insufficiency. Other patient characteristics including race, comorbidities and smoking status were documented in Table 1. Table 2 demonstrates the results of chi-squared analysis. This study noted significant patient-perceived improvement in swelling and pain (91.4% with P < 0.00001; 85.7% with P = 0.00002 respectively) and patient-reported ease of use of the FLX device (85.7% with P = 0.00002). Additional secondary findings included a majority of patients reporting being trained on how to use FLX and also maintaining compliance with the device (69.2% with P = 0.005; 67.3% with P = 0.012 respectively).
CONCLUSIONS: FLX APCD use has been found to demonstrate desirable patient-reported outcomes as a general trend. The participants in this study noted statistically significant subjective improvement in swelling and pain, ease of use of device and adherence to training and compliance with device. FLX appears to be positively received by patients, and the authors recommend its consideration for management of bilateral lower extremity phlebolymphedema.