运动干预对妇科癌症术后下肢淋巴水肿影响的Meta分析  

The effect of exercise in reducing and controlling gynecological cancer surgery related lower extremity lymphedema:A Meta-analysis

作　　者：连蕊[1] 朱丹[2] 李琳[1] 张岩[1] LIAN Rui;ZHU Dan;LI Lin;ZHANG Yan(Department of Gynecology,First Hospital of Peking University,100034 Beijing,China;Department of Nursing,First Hospital of Peking University,100034 Beijing,China)

机构地区：[1]北京大学第一医院妇科,北京100034 [2]北京大学第一医院护理部,北京100034

出　　处：《中国妇产科临床杂志》2025年第2期103-107,共5页Chinese Journal of Clinical Obstetrics and Gynecology

基　　金：北京大学第一医院院内青年临床研究专项(2024YC22)。

摘　　要：目的评估运动干预对妇科癌症术后下肢淋巴水肿管理的效果。方法检索Pub Med、Cochrane Library、Embase、万方数据库、中国知网等数据库中建库至2023年9月的随机对照试验,并用Rev Man 5.4软件进行Meta分析。结果纳入11篇符合入排标准的文献,共854例研究对象。Meta分析显示,运动干预可以降低下肢淋巴水肿发生率(OR=0.35,95%CI:0.24~0.51,P<0.001)、中重度淋巴水肿发生率(OR=0.33,95%CI:0.19~0.58,P<0.001),减少下肢体积(SMD=-1.31,95%CI:-2.44~-0.18,P=0.02),延缓水肿出现时间(MD=3.42,95%CI:2.56~4.28,P<0.001),减轻相关症状(MD=-2.10,95%CI:-3.45~-0.76,P=0.002)及疼痛(SMD=-1.46,95%CI:-32.86~-0.06,P=0.002),改善患者生活质量(SMD=0.75,95%CI:0.03~1.47,P=0.04)。结论运动干预可以降低妇科癌症术后下肢淋巴水肿的发生率、延缓淋巴水肿出现时间、减轻相关症状,改善患者生活质量,但纳入研究运动方案多样且样本量较小,未来仍需要更多大样本、高质量的随机对照试验。Objective To evaluate the effect of exercise intervention on the management of lower extremity lymphedema after gynecological cancer surgery. Methods Pub Med, the Cochrane Library, Embase, Wanfang Database, China National Knowledge Infrastructure(CNKI) and other databases were searched for randomized controlled trials(RCT) until September 2023. RevMan5.4 was used for Meta-analysis. Results A total of 11 RCTs meeting the inclusion criteria were included, involving 854 study subjects. Metaanalysis showed that exercise reduced the incidence of lower limb lymphedema(OR=0.35, 95% CI: 0.24-0.51, P <0.001) and moderate to severe lymphedema(OR =0.33, 95%CI: 0.19-0.58, P <0.001), reduced leg volume(SMD =-1.31, 95%CI:-2.44 ~-0.18,P =0.02), delayed onset of lymphedema(MD =3.42, 95%CI : 2.56-4.28, P <0.001), reduced symptoms(MD =-2.10,95%CI:-3.45--0.76, P =0.002) and pain(SMD=-1.46, 95%CI:-32.86--0.06, P =0.002), improved quality of life(SMD=0.75,95%CI: 0.03-1.47, P =0.04). Conclusions Exercise reduces the lower limb lymphedema incidence, delays the onset, alleviates symptoms, and improves the quality of life for post-gynecological cancer surgery patients. However, there were heterogeneous in the exercise modes and the sample sizes were small in included studies. More large-sample, high-quality studies are needed in the future.

关 键 词：妇科癌症 下肢淋巴水肿 运动干预 随机对照试验 META分析 

分 类 号：R737.3[医药卫生—肿瘤]