Background: Although lower limb lymphedema (LLL) is more or equally as frequent and harmful as upper limb lymphedema after cancer treatment, there are only a few studies on this topic. Cancer-related secondary LLL not only has physical implications, but also affects quality of life among patients who underwent gynecological cancer treatment. Despite numerous studies of various therapies, the optimal treatment for cancer-related LLL is still unknown.
背景:盡管在癌癥治療后，下肢淋巴水腫(LLL)的發(fā)生頻率和危害與上肢淋巴水腫相當(dāng)，但有關(guān)該課題的研究很少。癌癥相關(guān)的繼發(fā)性LLL不僅對(duì)身體有影響，還會(huì)影響接受婦科癌癥治療的患者的生活質(zhì)量。盡管對(duì)各種治療方法進(jìn)行了大量的研究，但癌癥相關(guān)的LLL的最佳治療方法仍然未知。
Objectives: We aimed to investigate the efficacy of lumbar sympathetic ganglion block (LSGB) in patients with secondary LLL in the present study.
目的:本研究旨在探討腰交感神經(jīng)節(jié)阻滯(lgb)治療繼發(fā)性LLL的療效。
Study Design: This study is a retrospective study.
研究設(shè)計(jì):本研究為回顧性研究。
Setting: A single academic hospital, outpatient setting.
設(shè)置:一個(gè)單一的學(xué)術(shù)醫(yī)院，門診部。
Methods: A total of 30 patients with secondary unilateral LLL and failed complex decongestive treatment, from January 2017 through May 2021, were reviewed for inclusion in this study. The patients underwent fluoroscopy-guided LSGB 2 times with the help of digital subtraction angiography at 3-day intervals. Leg circumference was measured, and the volume of the leg was calculated before surgery, on the first day after the first surgery, on the first day after the second surgery, and on the seventh day after the second surgery. The World Health Organization Quality of Life Instrument Questionnaire scores were monitored before and after LSGB.
方法:從2017年1月到2021年5月，共有30例繼發(fā)性單側(cè)LLL患者和復(fù)雜去充血治療失敗的患者被納入本研究。在數(shù)字減影血管造影的幫助下，患者每隔3天進(jìn)行2次透視引導(dǎo)下的LSGB檢查。術(shù)前、第一次手術(shù)后第一天、第二次手術(shù)后第一天、第二次手術(shù)后第7天分別測(cè)量腿圍，計(jì)算腿部容積。在LSGB治療前后監(jiān)測(cè)世界衛(wèi)生組織生活質(zhì)量工具問卷評(píng)分。
Results: The leg circumference and volume decreased significantly from baseline after the treatment (P < 0.001). One week after 2 rounds of LSGB, the physical health score, psychological score, and social relationships score were higher than those before treatment (all P < 0.05). There was no difference in the environmental health score (P = 0.2731).
結(jié)果:治療后患者腿圍、腿體積較基線明顯減小(P < 0.001)。2輪治療后1周，患者身體健康評(píng)分、心理評(píng)分、社會(huì)關(guān)系評(píng)分均高于治療前(均P < 0.05)。環(huán)境健康評(píng)分差異無統(tǒng)計(jì)學(xué)意義(P = 0.2731)。
Limitations: This study was limited by its sample size and retrospective observational design.
局限性:本研究受樣本量和回顧性觀察設(shè)計(jì)的限制。
Conclusions: LSGB can be a safe and effective treatment option for patients with secondary LLL after gynecological cancer treatment.
結(jié)論:對(duì)于婦科腫瘤治療后繼發(fā)LLL患者，LSGB是一種安全有效的治療選擇。
The lower limb circumferences were dramatically reduced.After the first and the second LSGB, the leg circumference of the detected site was reduced, and the degree of reduction was obvious between the 2 times (P < 0.05), except for the foot. However, the degree of leg circumference reduction one week after the second LSGB showed no difference compared with one day after the second LSGB (P > 0.05). 下肢周長(zhǎng)明顯減小。第一次和第二次LSGB后，檢測(cè)部位腿部周長(zhǎng)減小，2次之間減小程度明顯(P < 0.05)，除足外。然而，第二次LSGB后一周的腿圍縮小程度與第二次LSGB后一天無差異(P > 0.05).
The patient’s leg volume decreased as the number of treatment increased, with the smallest leg volume at one week after the LSGB treatment (Fig. 5). Compared with baseline, there was a vast difference between pre and post7 (P < 0.05), and between post1 and post7 (P < 0.05).
患者的腿體積隨著治療次數(shù)的增加而減少，在LSGB治療一周后腿體積最小。與基線相比，pre和post7之間有顯著差異(P < 0.05)， post1和post7之間有顯著差異(P < 0.05)。
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