The Effectiveness Of Intervention Treatment For Postoperative Patients With Early Breast Cancer-Related Lymphedema

?Objectives?This study focuses on the assessment and diagnosis for postoperative patients with early breast cancer-related lymphedema.Early intervention measure of complex decongestive therapy(CDT)is implemented with an aim to observe the intervention result,and provide certain reference evidence for the early detection,early diagnosis,and early intervention for post-surgery patients with early breast cancer-related lymphedema.?Methods?A historical control study was used.42 inpatients and outpatients who were diagnosed with early lymphedema from January,2016 to October,2016 at the Breast Surgery Department of Hainan Provincial People's Hospital were set as the historical control group and 44 patients who met the inclusion criteria from November,2016 to August,2017 were set as the experimental group.Routine guidance measures were adopted in the control group while routine guidance combined with complex decongestive therapy(CDT)measures were taken in the experimental group.Follow-ups were conducted in 1-month,3-month,6-month period after the intervention was implemented.Comparisons of changes in arm circumference,lymphedema symptoms experience,improvement rate and progression of lymphedema,as well as disabilities of arm,shoulder and hand scale(DASH)were made between the two groups so as to assess the treatment effect of CDT.?Results?1.Baseline condition of the two groups: There were no statistical differences regarding demographic data and disease-related data between the two groups before intervention(P>0.05).2.Arm circumference of the two groups: In comparison with pre-intervention data,the arm circumference of the experimental group gradually decreased.The circumference of hand and the circumference of 5cm below acromion demonstrated statistical differences only six months after the treatment(P<0.05)with all the other positions showing statistical significance after treatment(P<0.05),whereas the circumference of the control group increased gradually with the passage of time.3.Lymphedema symptoms experience of the two groups: the subjective symptoms of the patients in the two groups were not comparable before intervention(P>0.05).At the same treatment time,comparing the experimental group and control group,the number of subjective symptoms from the patients in the experimental group decreased obviously with incidence generally showing an downward trend,especially in 6 months after intervention.The incidence of symptoms in the experimental group was significantly lower than that in the control group(P<0.05).With regards to comparison inside the group,such four subjective symptoms as limitations of shoulder,elbow,wrist and finger only showed obvious decline in the experimental group six months after the intervention(P<0.05)while there were no significant differences in the incidence of inflexible arms or arm limitation before and after intervention(P>0.05).4.The improvement rate of lymphedema in the two groups: No obvious improvement of the early stage lymphedema was seen in the two groups in 1 month and 3 months after the intervention(P>0.05)while improvement rate in the experimental group is obviously higher than that in the control group six months after the intervention,showing statistical differences(P<0.01).5.Progression of lyphedema of the two groups: The progression of the control group was obviously higher than that of the experimental group 3 months and 6months after the intervention,showing statistical differences(P<0.01).6.The assessment of disabilities of arm,shoulder and hand scale(DASH)of the two groups: The DASH score in the experimental group is significantly lower than that in the control group 3 months and 6 months after the intervention,showing statistical differences(P<0.01).Conclusion: After CDT intervention is taken among post-surgery patients with early breast cancer-related lymphedema,it can promote the circumfluence of lymphatic fluid,relieve the edema of the affected upper limb,reduce the incidence of lymphedema symptoms,control and delay the development of early lymphedema,enhance daily activities ability of the affected limbs,improve the patients' subjective feelings such as psychology,sleep,self-confidence,and so on.However,certain limitations exist in the aspects of swelling-reduction,flexibility and mobility of such positions as the fingers,palms,shoulders and more active joints.