Prediktori efikasnosti kompleksne dekongestivne terapije kod pacijentkinja sa limfedemom ruke nakon malignog tumora dojke

  • Dragana Bojinović-Rodić Zavod za fizikalnu medicinu i rehabilitaciju " Dr Miroslav Zotović", Banja Luka
  • Samra Pjanić Zavod za fizikalnu medicinu i rehabilitaciju „Dr Miroslav Zotović“, Banja Luka
  • Tamara Popović Institute for Physical Medicine and Rehabilitation „Dr Miroslav Zotović“, Banja Luka, Medical Faculty, University of Banja Luka2
  • Tatjana Nožica-Radulović Zavod za fizikalnu medicinu i rehabilitaciju „Dr Miroslav Zotović“, Banja Luka, Medicinski fakultet Univerziteta u Banjaluci
DOI: https://doi.org/10.5937/scriptamed52-30638
Ključne reči: Karcinom dojke, Limfoedem, Modaliteti fizikalne terapije, Kompresivni zavoji, Drenaža, Ishod liječenja

Sažetak


Uvod / Cilj: Najčešći oblik terapije limfedema je kompleksna dekongestivna terapija (KDT). Efikasnost KDT kod  pacijentkinja sa limfedemom nakon malignog  tumora dojke evidentirana je u mnogim studijama, ali prediktivni faktori ishoda ove terapije još nisu dovoljno istraženi. Cilj ovog istraživanja bio je identifikovati nezavisne prediktore efikasnosti  KDT kod pacijentkinja  sa limfedemom ruke nakon malignog tumora dojke tokom intenzivne faze terapije.

Metode: Prospektivna studija obuhvatila je 51 pacijentkinju sa limfedemom ruke nakon liječenja malignog tumora dojke koje su provele tronedeljni program KDT, jednom dnevno, 5 dana sedmično. Kliničke i demografske karakteristike pacijentkinja,  karakteristike liječenja karcinoma dojke, karakteristike limfedema i KDT karakteristike prikupljene su i procijenjene prema njihovoj prediktivnoj vrijednosti. Uticaj pojedinih prediktora na stepen smanjenja limfedema procijenjen je multivarijantnom linearnom regresionom analizom.

Rezultati: Srednja dob pacijentkinja  je bila 58,1 ± 8,0 (95% CI: 55,8-60,3), srednja vrijednost BMI  28,4 kg / m2 (95% CI: 27,2-29,6). Prosječno trajanje limfedema iznosilo  je 36,5 ± 43,9 mjeseci (95% CI: 24,1-48,8). Prosječna veličina limfedema prije terapije bila je 6,99 ± 5,36%, a srednji stepen smanjenja limfedema 63,7 ± 28,6%. Prosječna komplijansa nošenja bandaže iznosila je 217,5 ± 97,8 sati (95% CI: 190,0-245,0), a 7 (13,7%) bolesnika imalo je erizipel ipsilaeralne ruke u anamnezi. U posmatranju doprinosa svakog prediktora pojedinačno, statistički značajan najveći doprinos predviđanju stepena smanjenja limfedema imala je veličina limfedema prije terapije (p <0,001), zatim anamneza erizipela (p <0,01) i dob pacijenata  (p <0,05).

Zaključak: Veličina limfedema prije terapije najvažniji je prediktivni faktor efikasnosti KDT kod pacijenata sa limfedemom ruke nakon liječenja  malignog tumora dojke. Ovo istraživanje je  takođe identifikovalo anamnezu  erizipela i dob pacijenata kao nezavisne prediktore efikasnosti KDT.

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Objavljeno
2021/06/29
Broj časopisa
Vol. 52 Br. 2 (2021): Q2/June
Rubrika
Originalni naučni članak
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