CAJ | 학술논문

目的：比较乳腺癌不同术式后患肢活动、感觉障碍、淋巴水肿的发病情况，评价患肢功能障碍发病的临床相关因素。方法2005年~2012年235例乳腺癌患者按腋窝淋巴结处理术式不同分为腔镜腋窝淋巴结清扫组(A组，n=120)和常规腋窝淋巴结清扫组(B组，n=115)。测量患者患侧上肢肩关节前屈、后伸、外展、内收活动度，并与对侧比较；测量双上肢尺骨鹰嘴上下15 cm的周径，随访患者术后半年、1年、2年患肢功能障碍的发病情况。结果两组患者术后半年、1年、2年患肢在肩关节活动、感觉方面(麻木和疼痛)无显著性差异(P>0.05)；B组患肢水肿的发病率高于A组(P<0.05)。放疗与患肢淋巴水肿有关联(P<0.05)。结论腔镜腋窝淋巴结清扫术与常规腋窝淋巴结清扫术相比，能降低乳腺癌患者术后患肢淋巴水肿的发病率，但在肩关节活动、感觉障碍方面无差别。术后放疗是增加患肢淋巴水肿发生的危险因素。
목적：비교유선암불동술식후환지활동、감각장애、림파수종적발병정황，평개환지공능장애발병적림상상관인소。방법2005년~2012년235례유선암환자안액와림파결처리술식불동분위강경액와림파결청소조(A조，n=120)화상규액와림파결청소조(B조，n=115)。측량환자환측상지견관절전굴、후신、외전、내수활동도，병여대측비교；측량쌍상지척골응취상하15 cm적주경，수방환자술후반년、1년、2년환지공능장애적발병정황。결과량조환자술후반년、1년、2년환지재견관절활동、감각방면(마목화동통)무현저성차이(P>0.05)；B조환지수종적발병솔고우A조(P<0.05)。방료여환지림파수종유관련(P<0.05)。결론강경액와림파결청소술여상규액와림파결청소술상비，능강저유선암환자술후환지림파수종적발병솔，단재견관절활동、감각장애방면무차별。술후방료시증가환지림파수종발생적위험인소。
Objective To compare the incidence of limb dysfunction, sensory disturbance and lymphedema after different treatment methods in breast cancer patients, and evaluate the clinically relevant factors of limb dysfunction. Methods According to the different pro-cessing operation of axillary lymph nodes, 235 patients with breast cancer during 2005 to 2012 were divided into axillary lymph node dissec-tion group in Mastoscopy (group A, n=120) and routine axillary lymph node dissection group (group B, n=115). The flexion, extension, ab-duction, adduction activity of the ipsilateral shoulder were compared with the contralateral, and the circumference of the up-and-down 15 cm of both upper limbs olecroanon were measured. The incidence of limb dysfunction of the patients was followed up in 6 months, 1 year and 2 years. Results There was no significant difference in limb activity and sensory disturbance between 2 groups 6 months, 1 year and 2 years after operation (P>0.05), the incidence of limb lymphedema was higher in group B than in group A (P<0.05). Radiotherapy was relat-ed with limb lymphedema in both groups (P<0.05). Conclusion Compared with the conventional axillary lymph node dissection, endoscop-ic axillary lymph node dissection can reduce the incidence of limb lymphedema after operation, but there was no significant difference in the limb activity and sensory disturbance between 2 groups. Postoperative radiotherapy is a risk to increase the occurrence of limb lymphedema.