以质量求发展，以服务铸品牌

护理学报 ›› 2021, Vol. 28 ›› Issue (4): 26-30.doi: 10.16460/j.issn1008-9969.2021.04.026

• 循证护理 • 上一篇    下一篇

延迟自体乳房重建术对上肢淋巴水肿治疗效果的系统评价

从维莲1,2, 周春兰2,3, 胡明钰2, 刘丽萍2   

  1. 1.中国科学院大学附属肿瘤医院（浙江省肿瘤医院）,浙江 杭州 310022;
    2.南方医科大学南方医院,广东 广州 510515;
    3.南方医院JBI循证护理合作中心,广东 广州 510515
  • 收稿日期:2020-07-20 出版日期:2021-02-25 发布日期:2021-03-12
  • 通讯作者: 周春兰（1962-）,女,湖南益阳人,硕士,主任护师,博士研究生导师,护理部主任。E-mail:lanchun200488@126.com
  • 作者简介:从维莲（1995-）,女,安徽六安人,硕士学历,护师。
  • 基金资助:
    2019年度南方医院护理创优-循证实践专项项目（2019EBNc002）

Effect of Delayed Autologous Breast Reconstruction on Patients with Upper Extremity Lymphedema: A systematic Review

CONG Wei-lian1,2, ZHOU Chun-lan2,3, HU Ming-yu2, LIU Li-ping2   

  1. 1.Cancer Hospital of University of Chinese Academy of Sciences Zhejiang Cancer Hospital, Hangzhou 310022, China;
    2.Nanfang Hospital, Southern Medical University, Guangzhou 510515, China;
    3.PR China Nanfang Nursing Centre for Evidence-based Practice: A JBI Centre of Excellence, Guangzhou 510515, China
  • Received:2020-07-20 Online:2021-02-25 Published:2021-03-12

PDF (PC)

116

赞

摘要： 目的 系统评价延迟自体乳房重建术治疗上肢淋巴水肿的效果。方法 检索Cochrane Library、PubMed、Embase、Scopus、Web of Science数据库,搜集关于延迟自体乳房重建术对上肢淋巴水肿治疗效果的研究,检索时间为建库至2020年6月。由2名研究员独立筛选符合标准的文献并进行数据提取,采用澳大利亚JBI循证卫生保健中心的文献质量评价工具对纳入文献质量进行评价,采用RevMan 5.3软件进行Meta分析。结果 纳入11篇文献,其中6篇纳入定量合成分析,Meta分析结果显示,64.8%（95%CI,0.32~0.88）的患者无论是否接受淋巴结移植,进行乳房重建术后淋巴水肿均有所改善。亚组分析结果显示,84.4%（95%CI,0.72~0.92）的患者在接受乳房重建术和淋巴结移植后淋巴水肿有所改善,而仅有21.9%（95%CI,0.14~0.33）的患者在只接受乳房重建术后淋巴水肿有所改善。结论 延迟自体乳房重建术可以改善乳腺癌患者术后上肢淋巴水肿,其中淋巴结移植可能是促进淋巴水肿改善的因素。

关键词: 乳房重建, 乳腺癌, 淋巴水肿, Meta分析

Abstract: Objective To systematically evaluate the effect of delayed autologous breast reconstruction in the treatment of upper limb lymphedema. Methods The databases of Cochrane Library, PubMed, Embase, Scopus and Web of Science were searched to collect studies on therapeutic effect of delayed autologous breast reconstruction on upper limb lymphedema from the inception to June 2020. The eligible articles were independently screened by two researchers and the data were extracted. The quality of the included literature was evaluated by the literature quality evaluation tool of the JBI, and the RevMan5.3 software was used for Meta analysis. Results Eleven articles were included, of which six were quantitative synthetic analysis. Meta analysis showed that 64.8%(95% confidence interval, 0.32~0.88) of the patients reduced lymphedema after breast reconstruction whether they received lymph node transplantation or not. Subgroup analysis showed that 84.4% (95% confidence interval, 0.72~0.92) of patients reduced lymphedema after breast reconstruction and lymph node transplantation,while only 21.9%(95% confidence interval,0.14~0.33) reduced lymphedema after breast reconstruction. Conclusion Delayed autologous breast reconstruction can improve upper limb lymphedema in patients with breast cancer, and lymph node transplantation may be the largest contributing factor leading to lymphedema improvement.

Key words: breast reconstruction, breast cancer, lymphedema, Meta analysis

中图分类号: 

  • R473.73
[1] Taghian NR, Miller CL, Jammallo LS, et al.Lymphedema Following Breast Cancer Treatment and Impact on Quality of Life: A Review[J]. Crit Rev Oncol Hematol,2014,92(3):227-234. DOI:10.1016/j.critrevonc.2014.06.004.
[2] 杨伊兰,龙笑.继发性淋巴水肿的治疗进展[J].医学研究杂志,2020,49(3):170-174.
[3] Chang DW, Kim S.Breast Reconstruction and Lymphedema[J]. Plast Reconstr Surg,2010,125(1):19-23. DOI:10.1097/PRS.0b013e3181c49477.
[4] Ciudad P, Manrique OJ,Bustos SS,et al.Combined Microvascular Breast and Lymphatic Reconstruction with Deep Inferior Epigastric Perforator Flap and Gastroepiploic Vascularized Lymph Node Transfer for Postmastectomy Lymphedema Patients[J]. Gland Surg,2020,9(2):512-520. DOI:10.21037/gs.2020.01.14.
[5] Sinelnikov MY, Chen K,Sukorceva NS,et al.A Clinical Case of Breast Reconstruction with Greater Omentum Flap for Treatment of Upper Extremity Lymphedema[J].Plast Reconstr Surg Glob Open,2019,7(9):e2402.DOI:10.1097/GOX.0000000000002402 .
[6] 守丹,梁欣,黄金丹,等.抗阻运动对血液透析患者血压控制及运动耐量恢复效果Meta分析[J].护理学报,2020,27(15):44-49.
[7] 陈月红,杜亮,耿兴远,等. 无对照二分类数据的Meta分析在RevMan软件中的实现[J].中国循证医学杂志,2014, 14(7):889-896.
[8] Yang Z, Huang S, Wang J, et al.A Retrospective Study of Lymphatic Transverse Rectus Abdominis Myocutaneous/Deep Inferior Epigastric Perforator Flaps for Breast Cancer Treatment-induced Upper-limb Lymphoedema[J].Sci Rep,2017,7(1):80. DOI:10.1038/s41598-017-00164-1.
[9] De Brucker B, Zeltzer A, Seidenstuecker K, et al.Breast Cancer-related Lymphedema:Quality of Life after Lymph Node Transfer[J]. Plast Reconstr Surg, 2016,137(6):1673-1680. DOI:10.1097/PRS.0000000000002169.
[10] Inbal A, Teven CM, Chang DW.Latissimus Dorsi Flap with Vascularized Lymph Node Transfer for Lymphedema Treatment: Technique, Outcomes, Indications and Review of Literature[J]. J Surg Oncol,2017,115(1):72-77.DOI:10.1002/jso.24347.
[11] Chen R, Mu L, Zhang H, et al.Simultaneous Breast Reconstruction and Treatment of Breast Cancer-related Upper Arm Lymphedema with Lymphatic Lower Abdominal Flap[J]. Ann Plast Surg,2014,73(Suppl):S12-17. DOI:10.1097/SAP.0000000000000322.
[12] Saaristo AM, Niemi TS, Viitanen TP, et al.Microvascular Breast Reconstruction and Lymph Node Transfer for Postmastectomy Lymphedema Patients[J]. Ann Surg, 2012,255(3):468-473. DOI:10.1097/SLA.0b013e3182426757.
[13] Lee KT, Lim SY, Pyun JK, et al.Improvement of Upper Extremity Lymphedema after Delayed Breast Reconstruction with an Extended Latissimus Dorsi Myocutaneous Flap[J]. Arch Plast Surg, 2012,39(2):154-157. DOI:10.5999/aps.2012.39.2.154.
[14] Abbas Khan MA, Mohan A, Hardwicke J, et al.Objective Improvement in Upper Limb Lymphoedema Following Ipsilateral Latissimus Dorsi Pedicled Flap Breast reconstruction-a Case Series and Review of Literature[J].J Plast Reconstr Aesthet Surg, 2011,64(5):680-684. DOI:10.1016/j.bjps.2010.06.014.
[15] Blanchard M, Arrault M, Vignes S.Positive Impact of Delayed Breast Reconstruction on Breast-cancer Treatment-related Arm Lymphoedema[J].J Plast Reconstr Aesthet Surg,2012,65(8):1060-1063. DOI:10.1016/j.bjps.2012.03.019.
[16] Fosnot J, Fischer JP, Wu LC, et al.The Patient’s Perspective on the Effect of Autologous Breast Reconstruction on Lymphedema[J]. Ann Plast Surg, 2015,75(2):149-152. DOI:10.1097/SAP.0000000000000115.
[17] Siotos C, Hassanein AH, Bello RJ,et al.Delayed Breast Reconstruction on Patients with Upper Extremity Lymphedema: A Systematic Review of the Literature and Pooled Analysis[J]. Ann Plast Surg,2018,81(6):730-735.DOI:10.1097/SAP.0000000000001542.
[18] Parrett BM, Sepic J, Pribaz JJ.The Contralateral Rectus Abdominis Musculocutaneous Flap for Treatment of Lower Extremity Lymphedema[J]. Ann Plast Surg, 2009,62(1):75-79. DOI:10.1097/SAP.0b013e31817439de.
[19] Siotos C, Sebai ME, Wan EL, et al.Breast Reconstruction and Risk of Arm Lymphedema Development: A Meta-analysis[J]. J Plast Reconstr Aesthet Surg, 2018,71(6):807-818.DOI:10.1016/j.bjps.2018.01.012.
[20] Forte AJ, Cinotto G, Boczar D, et al.Lymph Node Transfer Combined with Deep Inferior Epigastric Perforators and Transverse Rectus Abdominis Myocutaneous Procedures: A Systematic Review[J]. Gland Surg, 2020,9(2):521-527.DOI:10.21037/gs.2020.02.11.
[21] Raju A, Chang DW.Vascularized Lymph Node Transfer for Treatment of Lymphedema:A Comprehensive Literature Review[J]. Ann Surg, 2015,261(5):1013-1023.DOI:10.1097/SLA.0000000000000763.
[1] 陆涵, 赵媛, 朱晓丽, 林惠仙, 史婷婷. 基于改良早期预警评分护送方案在急危重症患者院内转运中应用效果的Meta分析[J]. 护理学报, 2021, 28(4): 19-25.
[2] 徐思英, 黄莹, 刘丽华, 胡雅. 基于互联网认知行为疗法对产妇负性情绪干预效果的Meta分析[J]. 护理学报, 2021, 28(4): 36-42.
[3] 江丽玲, 詹梦梅, 黄秋霞, 李立群, 张淑, 龚晶晶, 王建宁. 乳腺癌患者性生活体验质性研究的Meta整合[J]. 护理学报, 2021, 28(1): 33-37.
[4] 路莉静, 孟爱凤, 程芳, 邾萍, 智晓旭, 汤琳, 王鹏程. 乳腺癌患者就医延迟原因质性研究的Meta整合[J]. 护理学报, 2021, 28(1): 38-44.
[5] 裴露斯, 杨雪梅, 翟田田, 赵亚芸, 冯兰棱, 张迁. 冷冻疗法降低化疗患者口腔黏膜炎发生的Meta分析[J]. 护理学报, 2020, 27(6): 23-28.
[6] 陈雯, 尹朱丹, 王赛男, 厉姝岑, 张雪芳. 接纳与承诺疗法对慢性疼痛干预效果的Meta分析[J]. 护理学报, 2020, 27(5): 22-27.
[7] 张丹妮, 朱慧, 谢传艺, 陈肖敏. 乳腺癌患者配偶照顾体验质性研究的Meta整合[J]. 护理学报, 2020, 27(4): 32-36.
[8] 王佳, 郝飞, 周慧敏. 叠加敷料粘贴法对乳腺癌患者PICC置管部位接触性皮炎的效果观察[J]. 护理学报, 2020, 27(4): 63-66.
[9] 徐绍莲, 臧谋红, 唐瑭, 霍丽萍, 朱贞祥. 肿瘤化疗患者植入式静脉输液港与PICC并发症发生情况Meta分析[J]. 护理学报, 2020, 27(3): 37-42.
[10] 史博慧, 吕爱莉, 王恋, 郭萍利, 马晓霞, 齐晶. 乳腺癌术后上肢淋巴水肿预防策略的证据总结[J]. 护理学报, 2020, 27(22): 32-38.
[11] 王江宁, 宋梅. 社区女性乳腺癌患者与非乳腺疾病者的情绪管理差异分析[J]. 护理学报, 2020, 27(22): 52-56.
[12] 庞艳, 林芳初, 李嫒, 宁佳惠, 周荣, 涂素华. 产后尿潴留发病危险因素Meta分析[J]. 护理学报, 2020, 27(20): 1-6.
[13] 邓妍, 胡露红. 乳腺癌双职双轨个案管理模式的应用效果观察[J]. 护理学报, 2020, 27(2): 21-23.
[14] 惠靖瑞, 熊振芳, 陈涵彬, 雷雨迟, 李敬文. 神阙穴贴敷治疗肿瘤患者化疗相关性便秘疗效的Meta分析[J]. 护理学报, 2020, 27(2): 38-42.
[15] 张惠婷, 刘琳妃, 罗庆华, 张丽娟. 80例乳腺癌女性患者术后1年患肢并发症的纵向研究及对策[J]. 护理学报, 2020, 27(2): 63-66.
Viewed
Full text


Abstract

Cited
  Shared   
[1] 王佳瑞, 李彦丽. 腕踝针干预寒湿凝滞型原发性痛经患者的效果观察[J]. 护理学报, 2021, 28(1): 1 -3 .
[2] 杜金磊, 陈志美, 龚莉, 宋杰, 王翔, 邹晓月. 气管拔管后嗓音障碍患者系统康复训练的效果观察[J]. 护理学报, 2021, 28(1): 4 -8 .
[3] 梁红宽, 罗蔼, 宋瑜, 肖东. 降低扫描式葡萄糖监测系统传感器非预期更换率的品管圈实践[J]. 护理学报, 2021, 28(1): 9 -12 .
[4] 杨芳, 杨艳, 贺琳晰. OEC管理模式在新型冠状病毒核酸检测采集中心护理管理中的应用[J]. 护理学报, 2021, 28(1): 13 -16 .
[5] 赵明曦, 孙建华, 李若祎, 侯锦, 李尊柱, 罗红波, 奉爱萍, 李欣, 李奇. 床旁超声在重症患者肠内营养的应用进展[J]. 护理学报, 2021, 28(1): 17 -21 .
[6] 姚露, 陈雪萍, 刘欣, 陈姬, 汪梦鑫. 运动传感设备在衰弱老年人中的应用进展[J]. 护理学报, 2021, 28(1): 22 -26 .
[7] 汪梦月, 蒋园园, 陈妍, 盛少婷. 老年综合评估对预防老年患者护理不良事件发生的Meta分析[J]. 护理学报, 2021, 28(1): 27 -32 .
[8] 江丽玲, 詹梦梅, 黄秋霞, 李立群, 张淑, 龚晶晶, 王建宁. 乳腺癌患者性生活体验质性研究的Meta整合[J]. 护理学报, 2021, 28(1): 33 -37 .
[9] 路莉静, 孟爱凤, 程芳, 邾萍, 智晓旭, 汤琳, 王鹏程. 乳腺癌患者就医延迟原因质性研究的Meta整合[J]. 护理学报, 2021, 28(1): 38 -44 .
[10] 涂惠琼, 龙秀红, 沈琴庆. 148例先天性心脏病患儿术后主要照顾者的居家康复护理需求现状及影响因素分析[J]. 护理学报, 2021, 28(1): 45 -50 .