Lymphoedema: an underestimated health problem
Lymphoedema: an underestimated health problem
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DOI：
10.1093/qjmed/hcg126
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发表时间：
2003-10-01
影响因子：
13.3
通讯作者：
Mortimer, PS
中科院分区：
文献类型：
--
作者：
Moffatt, CJ;Franks, PJ;Mortimer, PS
背景资料：水肿/慢性水肿是一个重要的原因发病率的人口，但很少有人知道它的流行病学和影响的病人或health service.Aim：以确定的严重程度问题的慢性水肿在社会上，和可能的影响水肿的使用卫生资源，就业和病人的生活质量。联系专门淋巴水肿服务、特定门诊诊所、医院病房和社区服务（全科医生诊所和地区护士）的卫生专业人员，以提供西南伦敦社区信托内患者的信息。一个子集确定的患者interviewed.Results：在集水区，823例慢性水肿（粗患病率1.33/1000）。患病率随着年龄的增长而增加（65岁以上人群中为5.4/1 000），女性患病率更高（2.15比0.47/1 000）。只有529人（64%）接受治疗，尽管在集水区有两个淋巴水肿专科诊所。在接受采访的228名患者中，78%的水肿持续时间> 1年。在过去的一年中，64/218（29%）在受影响的地区发生了急性感染，17/64（27%）因静脉注射抗生素而入院。平均住院时间为12天，估计平均费用为2300英镑。水肿导致超过80%的人请假，影响9%的人的就业状况。生活质量低于正常水平，50%的人经历疼痛或不适，从他们的oedema.Discussion：慢性水肿是一个共同的问题，在社会上至少有100 000患者的痛苦，仅在英国，一个问题认识不足的卫生专业人员。由于癌症治疗以外的原因引起的水肿比一般认为的要普遍得多，但治疗资源主要是基于癌症，导致护理不平等。
Background: Lymphoedema/chronic oedema is an important cause of morbidity in the population, but little is known of its epidemiology and impact on patients or health services.Aim: To determine the magnitude of the problem of chronic oedema in the community, and the likely impact of oedema on use of health resources, employment and patient's quality of life.Design: Questionnaire-based survey.Methods: Health professionals from dedicated lymphoedema services, specific out-patient clinics, hospital wards and community services (GP clinics and district nurses) were contacted to provide information on patients from within South West London Community Trust. A subset of the identified patients was interviewed.Results: Within the catchment area, 823 patients had chronic oedema (crude prevalence 1.33/1000). Prevalence increased with age (5.4/1000 in those aged > 65 years), and was higher in women (2.15 vs. 0.47/1000). Only 529 (64%) were receiving treatment, despite two specialist lymphoedema clinics within the catchment area. Of 228 patients interviewed, 78% had oedema lasting > 1 year. Over the previous year, 64/218 (29%) had had an acute infection in the affected area, 17/64 (27%) being admitted for intravenous antibiotics. Mean length of stay for this condition was 12 days, estimated mean cost pound2300. Oedema caused time off work in > 80%, and affected employment status in 9%. Quality of life was below normal, with 50% experiencing pain or discomfort from their oedema.Discussion: Chronic oedema is a common problem in the community with at least 100 000 patients suffering in the UK alone, a problem poorly recognized by health professionals. Lymphoedema arising for reasons other than cancer treatment is much more prevalent than generally perceived, yet resources for treatment are mainly cancer-based, leading to inequalities of care.