Öz
Amaç
Lenfödem hastalarında ağrı, ödem, uyku bozuklukları gibi hastanın yaşam kalitesini (QoL) bozan sorunlar sıklıkla görülmektedir. Daha önce kompleks dekonjestif tedavinin (KDT) ağrı, ekstremite hacmi ve QoL üzerindeki olumlu etkileri zaten bildirilmişti. Bu çalışmanın amacı, kanser cerrahisi sonrası lenfödem gelişen hastalara uygulanan KDT’nin birinci fazının ağrı, ekstremite hacmi, QoL gibi diğer semptomların yanı sıra uyku kalitesi üzerine etkilerini araştırmaktır.
Gereç ve Yöntem
Çalışmaya, kanser ameliyatı sonrasında üst veya alt ekstremite lenfödemi gelişen toplam 48 kadın hasta (23 meme kanseri ve 25 ürojinekolojik kanser) dahil edildi. Hastalar tedaviye başlamadan önce QoL, ağrı, ekstremite hacmi, tıbbi geçmiş ve demografik veriler açısından sorgulandı. Ardından, üç hafta boyunca haftada beş gün olmak üzere toplam 15 seans KDT uygulandı ve hastalar yeniden değerlendirildi. Ağrı şiddeti görsel analog skala ile, uyku kalitesi Pittsburgh uyku kalitesi indeksi ile, yaşam kalitesi lenfödem QoL anketi ile değerlendirildi ve ekstremite hacmi Frustum formülü kullanılarak ölçüldü ve hesaplandı.
Bulgular
Tedavi sonrasında üst ekstremitesinde lenfödem gelişen grubun ağrı (p<0,001), ekstremite hacmi (p=0,015), uyku kalitesi (p<0,001) ve genel QoL skorunda (p=0,012) anlamlı iyileşme saptandı. Bununla beraber alt ekstremitesinde lenfödem gelişen grubun ağrı (p<0,001), ekstremite hacmi (p<0,001), uyku kalitesi (p<0,001) ve genel QoL skorunda da (p<0,001) anlamlı iyileşme elde edildi.
Sonuç
Bu çalışma, kanser cerrahisi sonrası lenfödem gelişen hastalarda KDT’nin uyku kalitesi üzerindeki etkilerini ortaya koyan ve ağrı, ekstremite hacmi ve QoL üzerindeki terapötik etkilerini doğrulayan ilk çalışmadır. Lenfödem hastalarında uyku bozukluklarının tedavi sürecinde KDT’nin uyku kalitesi üzerindeki terapötik faydalarının dikkate alınması önemlidir.
Anahtar Kelimeler: Lenfödem, kompleks dekonjestif terapi, uyku, yaşam kalitesi
Kaynakça
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