保留胸前神经和肋间臂神经的乳腺癌改良根治手术的疗效观察

目的分析乳腺癌改良根治手术中保留胸前神经和肋间臂神经临床疗效。方法将2012年3月至2013年10月经治疗的80例乳腺癌患者随机分为两组,观察组和对照组各40例,其中前者进行乳腺癌改良根治术中保留胸前神经和肋间臂神经,而后者在术中不保留胸前神经和肋间臂神经,对比观察两组手术时间、复发及肿瘤转移率(骨转移、侧腋窝转移)、不良反应(上肢水肿、上臂运动障碍、上臂术后感觉异常、胸大肌萎缩)发生率。结果两组手术时间比较,观察组手术时间长于对照组(85.0±15.0 min vs.70.5±10.0 min),差异有显著性(P0.05),术后复发及肿瘤转移率率、不良反应率明显高于对照组,组间比较差异有显著性(P0.05)。结论保留胸前神经和肋间臂神经的乳腺癌改良根治手术可显著降低术后复发率和转移率,减少不良反应及并发症的发生,具有临床应用价值。

Clinical observation of breast cancer operation anterior thoracic nerve and intercostobrachial nerve reservation.

Objective To investigate the clinical significance of breast cancer operation left anterior thoracic nerve and intereostobrachial nerve. Methods In March 2012 to 2013, 10 menstrual treatment of 2013 cases of breast cancer patients were randomly divided into two groups ： ob- servation group and control group. Clinical indexes of the 40 cases are compared including the former reserved in breast cancer modified radical chest and rib between ann nerves, while the latter in intraoperative does not retain his chest and rib between arm nerves. Prognosis and recurrence rate were observed in the two groups, including operation time, recurrence and metastasis rate （bone metastases, side axillary metastasis）, adverse reactions （upper extremity edema incidence, upper arm, upper ann movement disorders incidence of postoperative paresthesia, pectoralis major contraction rate）. Results Compared two groups of operation time, observation group operating time is longer than that of the control group （85.0 ＋ 15.0 rain vs. 70.5 ~ 10.0 rain）, with significant difference （ P 〈 0.05 ）. The rate of postoperative recurrence and metastasis rate and adverse reaction rate is significantly higher than that of the control group. There was statistically significant comparing the difference between groups （ P 〈0.05）. Conclu- sion Experiments show that implementation can significantly reduce the recurrence rate after operation and cancer metastasis rate of preserving ante- rior thoracic nerve and intercosto - brachial nerve in patients with breast cancer. The complications are reduced. The effect of this method is clinical- ly significant and be worthy of promotion.