The Correlation Between Fluid Distribution and Swelling or Subjective Symptoms of the Trunk in Lymphedema Patients: A Preliminary Observational Study.
The Correlation Between Fluid Distribution and Swelling or Subjective Symptoms of the Trunk in Lymphedema Patients: A Preliminary Observational Study.
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淋巴水肿患者的液体分布与躯干肿胀或主观症状的相关性：初步观察研究。
DOI：
10.1089/lrb.2020.0075
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发表时间：
2021-06
影响因子：
1.4
通讯作者：
Oshima C
中科院分区：
文献类型：
--
作者：
Hisano F;Niwa S;Nakanishi K;Mawaki A;Murota K;Fukuyama A;Takeno Y;Watanabe S;Fujimoto E;Oshima C
背景：手动淋巴引流（MLD）是乳腺癌相关性水肿（BCRL）的常用治疗方法之一。虽然MLD的主要目的是将患侧上肢和躯干中积聚的过多液体引流到身体通常引流的区域，但MLD的使用是根据肿胀和主观症状决定的，而不评估患侧区域是否有液体积聚。本研究的目的是检查BCRL患者样本中的躯干液体分布，并调查此类液体分布与肿胀或主观症状之间的任何相关性。方法和结果：对13名单侧上肢BCRL的女性进行了观察性研究。使用两种磁共振成像（MRI）序列评价液体分布：半傅立叶采集单激发快速自旋回波和三维双回波稳态。肿胀的存在由水肿治疗师确定，主观症状通过使用视觉模拟量表进行测量。在MRI上，没有参与者在躯干中有任何自由水信号。然而，7人有肿胀，所有13人都有某种主观症状的影响一侧的躯干。结论：这些结果表明，肿胀和主观症状与躯干液体的存在无关。对于这些病例，可能需要采用与MLD不同的方法来解决躯干肿胀和相关主观症状。检查躯干区域是否存在液体可能有助于更适当地使用MLD。
Background: Manual lymph drainage (MLD) is one of the common treatments for breast cancer-related lymphedema (BCRL). Although the primary goal of MLD is to drain the excessive fluid accumulated in the affected upper limb and trunk to an area of the body that drains usually, the use of MLD is decided based on swelling and subjective symptoms, without assessing whether there is fluid accumulated in the affected region. The purpose of this study was to examine truncal fluid distribution in a sample of BCRL patients and investigate any correlation between such fluid distribution and swelling or subjective symptoms. Methods and Results: An observational study was conducted with 13 women who had unilateral, upper extremity BCRL. Fluid distribution was evaluated by using two magnetic resonance imaging (MRI) sequences: half-Fourier acquisition single-shot turbo spin echo and three-dimensional double-echo steady-state. The presence of swelling was determined by lymphedema therapists, and subjective symptoms were measured by using a visual analog scale. On MRI, no participants had any free water signals in the trunk. However, seven had swelling and all 13 had some kind of subjective symptoms on the affected side of their trunk. Conclusions: These results suggest that swelling and subjective symptoms do not correlate with the presence of truncal fluid. For such cases, a different approach than MLD may be needed to address truncal swelling and related subjective symptoms. Checking for the presence of fluid in the truncal region may help MLD be used more appropriately.
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1.4
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