乳腺癌是全球女性中最常见的恶性肿瘤之一,发病率和死亡率都很高。上肢淋巴水肿(ULL)是乳腺癌术后常见的并发症,影响患者的日常活动和生活质量。充血淋巴疗法(DLT)和间歇性充气压缩(IPC)疗法是ULL的2种主要治疗方法。
■本研究旨在比较DLT与IPC与单独DLT在乳腺癌手术后ULL治疗中的疗效。
■PubMedCentral,Scopus,EMBASE,MEDLINE,Cochrane试验登记处,谷歌学者,和Clinicaltrials.gov数据库进行了全面搜索,以比较DLT与IPC和单独DLT在乳腺癌相关ULL患者中的随机对照试验(RCT)。使用RoB2工具评估偏倚风险。使用随机效应模型计算集合效应大小。
■通过系统搜索确定了总共1,894篇引文。其中,9项随机对照试验包括在分析中。体积减少百分比的合并标准化平均差(SMD)为0.63(95%置信区间[CI]:-0.24至1.50;I2=90.9%),显示单独DLT和DLT联合IPC之间没有显着差异(p=0.15)。两组之间的疼痛和沉重评分也相当。然而,外旋关节活动度有显著差异(SMD=0.62;95%CI:0.08-1.16;I2=23.8%),支持使用IPC的DLT。
■我们的研究结果表明,使用IPC的DLT和单独的DLT在乳腺癌手术后处理ULL方面表现出相似的发现,带IPC的DLT对外转关节活动能力影响较大。医疗保健提供者在选择最合适的治疗方式进行ULL管理时,应考虑患者的偏好和个人因素。
UNASSIGNED: Breast cancer is among the most prevalent malignancies in women worldwide, with substantial morbidity and mortality. Upper limb lymphedema (ULL) is a common complication after breast cancer surgery that affects patients\' daily activities and quality of life. Decongestive lymphatic therapy (DLT) and intermittent pneumatic compression (IPC) therapy are 2 primary treatment methods for ULL.
UNASSIGNED: This study aimed to compare the efficacy of DLT with IPC versus DLT alone in the management of ULL following breast cancer surgery.
UNASSIGNED: PubMed Central, SCOPUS, EMBASE, MEDLINE, Cochrane Trial Registry, Google Scholar, and Clinicaltrials.gov databases were comprehensively searched for randomized controlled trials (RCTs) comparing DLT with IPC and DLT alone in patients with breast cancer-related ULL. The risk of bias was evaluated using the RoB 2 tool. Pooled effect sizes were calculated using random-effects models.
UNASSIGNED: A total of 1,894 citations were identified by the systematic search. Of them, 9 RCTs were included in the analysis. The pooled standardized mean difference (SMD) for percentage volume reduction was 0.63 (95% confidence interval [CI]: -0.24 to 1.50; I 2 = 90.9%), showing no significant difference between the DLT alone and DLT combined with IPC (p = 0.15). Pain and heaviness scores were also comparable between the groups. However, there was a significant difference in external rotation joint mobility (SMD = 0.62; 95% CI: 0.08-1.16; I 2 = 23.8%), favoring DLT with IPC.
UNASSIGNED: Our findings suggest that DLT with IPC and DLT alone showed similar findings in managing ULL after breast cancer surgery, with DLT with IPC showing a greater impact on external rotation joint mobility. Healthcare providers should consider patient preferences and individual factors when selecting the most appropriate treatment modality for ULL management.