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哪种物理治疗干预措施在减少与乳腺癌相关的二次淋巴方面最有效? 一个系统审查和网络元分析
Raúl Alberto Aguilera-Eguía1,2, Pamela Serón3,4, Ruvistay Gutiérrez-Arias5,6
1Departamento de Salud Pública, Facultad de Medicina, Universidad Católica de la Santísima Concepción, Concepción 4090541, Chile.
Journal of clinical medicine
|October 16, 2025
概括
和多式方案在改善乳腺癌相关淋巴 (BCRL) 患者的生活质量和肩膀移动性方面表现有前途. 需要进一步的研究来证实这些发现,并指导临床决策.
科学领域:
- 在瘤学瘤学.
- 康复医学 康复医学 康复医学
- 证据综合 证据综合
背景情况:
- 与乳腺癌相关的淋巴 (BCRL) 显著影响患者的功能和生活质量 (QoL).
- 对于管理BCRL的各种物理治疗干预措施 (PTIs) 的比较有效性尚未得到充分证实.
- 为了评估BCRL的PTI,需要进行系统审查和网络元分析 (NMA).
研究的目的:
- 确定最有效的物理治疗干预措施 (PTIs) 管理与乳腺癌相关的淋巴 (BCRL).
- 通过网络元分析 (NMA) 来比较23种不同的PTI的有效性.
主要方法:
- 在多个数据库 (Medline/PubMed, LILACS, CENTRAL, PEDro, CINAHL) 进行了系统的搜索,直到2024年7月.
- 包括26项随机对照试验 (RCT),涉及1203名BCRL妇女,评估了23名PTI.
- 使用了频率网络元分析 (NMA) 和证据确定性的GRADE评估 (CoE).
主要成果:
- 与通常的标准护理 (USC) 相比,在6个月内在改善QOL方面表现出有效性,证据的确定性中等 (CoE).
- 多种模式的方法,有或没有家庭炼计划,显示出对外部旋转的中间好处,以及在肩部绑架 (低至中等Coe) 的潜在改善.
- 没有任何干预措施在其他主要或次要结局方面明显优于USC;在动态测量和压缩时,注意到了不良事件.
结论:
- 和多式联络项目被支持作为潜在的短期策略,以提高BCRL妇女的QoL和肩部移动性.
- 目前的证据主要是低至非常低的Coe,需要个性化治疗计划.
- 未来的高质量的RCT与标准化比较器,更大的样本和更长的随访对稳健的比较和改进的临床指导至关重要.
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