Multi-segment bioimpedance can assess patients with bilateral lymphedema
Multi-segment bioimpedance can assess patients with bilateral lymphedema
复制标题
DOI：
10.1016/j.bjps.2019.06.041
复制
发表时间：
2020-02-01
影响因子：
2.7
通讯作者：
Chen, Wei F.
中科院分区：
文献类型：
--
作者：
Qin, Evelyn S.;Bowen, Mindy J.;Chen, Wei F.
背景：生物阻抗谱 (BIS) 通过测量电流穿过细胞膜和组织时的肢体液体含量来评估淋巴水肿。 BIS 在临床上使用的主要设备模式有两种：单段生物阻抗 (SSB) 和多段生物阻抗 (MSB)，它们收集测量值的机制不同。在这项横断面研究中，我们通过参考吲哚菁绿（ICG）淋巴造影的结果来研究SSB和MSB在评估淋巴水肿方面的差异。方法：2017年5月1日至2017年11月31日期间，作为淋巴手术前评估的一部分，对就诊于我们科室的单侧和双侧淋巴水肿患者进行SSB和MSB评估。对患者进行ICG淋巴造影成像以确认淋巴水肿存在。记录并统计分析 SSB 和 MSB 的标准化设备测量输出。结果：对于单侧淋巴水肿，SSB 比 MSB (0.75) 更敏感。然而，MSB 还具有评估双侧淋巴水肿患者的能力，敏感性为 0.56，特异性为 0.60。此外，与 SSB 相比，MSB 与相对疾病严重程度具有更强的相关性，并量化了水肿的差异程度。相比之下，SSB 提供了一个经过操纵的数字，该数字是通过对异常肢体与正常肢体的比较得出的。医务人员报告 MSB 更容易执行，所有患者都报告 MSB 测量体验更有利。结论：虽然 SSB 和 MSB 都提供淋巴水肿的诊断信息，但 MSB 明显更容易执行，可以检测双侧疾病状态，并客观量化肢体液量，从而可以进行疾病跟踪以及手术和康复治疗效果的评估。在这项研究的基础上，我们部门已转向通用MSB测量。 (C) 2019 年英国整形、重建和美容外科医生协会。由爱思唯尔有限公司出版。保留所有权利。
Background: Bioimpedance spectroscopy (BIS) is used to assess lymphedema by measuring limb fluid content as an electric current passes through cell membranes and tissues. There are two primary device modalities, through which BIS is used clinically: single-segment bioimpedance (SSB) and multi-segment bioimpedance (MSB), which differ in their mechanisms of gathering measurements. In this cross-sectional study, we study the difference between SSB and MSB in evaluating lymphedema by referencing the results with indocyanine Green (ICG) lymphography.Methods: Patients with unilateral and bilateral lymphedema, presented to our department, were assessed with both SSB and MSB as part of a pre-lymphatic surgery evaluation between May 1, 2017, and November 31, 2017. Patients were imaged with ICG lymphography to confirm lymphedema presence. Standardized device measurement outputs from SSB and MSB were recorded and statistically analyzed.Results: SSB was more sensitive (0.9) than MSB (0.75) for unilateral lymphedema. However, MSB had the added ability to assess patients with bilateral lymphedema with a sensitivity of 0.56 and specificity of 0.60. Furthermore, MSB had a stronger correlation with relative disease severity compared to SSB and quantified the differential extents of edema. In comparison, SSB provided a manipulated number, which was derived from a comparison of the abnormal to the normal limb. Medical staffreported MSB being easier to perform, and all patients reported the MSB measurement experience being more favorable.Conclusions: While both SSB and MSB provide diagnostic information on lymphedema, MSB is notably easier to perform, can detect bilateral disease states, and objectively quantifies limb fluid volume, allowing for disease tracking and assessment of surgical and rehabilitative treatment efficacy. On the basis of this study, our department has switched to universal MSB measurement. (C) 2019 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.