乳腺癌Patey改良根治术中保留胸内侧神经的临床观察

目的探讨乳腺癌改良根治术中胸内侧神经的保留与否对患者术后生活质量的影响。方法 2000年1月至2009年12月,盐城卫生职业技术学院附属盐城市第一人民医院对I期、Ⅱ期乳腺癌患者实施乳腺癌根治术Patey根治术及在此基础上保留胸内侧神经的改良术,成功保留胸内侧神经的60例为保留组,而对照组选取2000年之前手术中切除了胸内侧神经的患者60例。结果两组随访期内保留组患侧胸肌厚度、肌力和上肢活动恢复均优于对照组,两者比较差异有统计学意义(P<0.01)。结论对Ⅰ期、Ⅱ期乳腺癌患者行保留胸内侧神经的改良根治术,既能达到根治目的,又有效地保留了患者术后的胸肌功能,对保持患者术后生活质量有实际的临床意义,具有安全可行性,值得临床推广应用。

Clinical Observation on Retaining Medial Pectoral Nerve in Patey Modified Radical Mastectomy of Breast Cancer

Objective To study effects of medial pectoral nerve preservation on the patient's quality of life after modified radical mastectomy.Methods From Jan.2000 to Dec.2009,among the cases of phase I,Ⅱbreast cancer patients treated by patey operation and by retaining medial pectoral nerve in modified radical mastectomy in Yancheng Health Vocational and Technical College Affiliated Yancheng First People's Hospital,60 cases of successful retaining medial pectoral nerve in were chosen as retaining group,while 60 cases with medial pectoral nerve removed before 2000 were selected as the control group.Results In the follow-up period,ipsilateral breast muscle thickness,muscle strength and restoration of upper limb activities in retaining group were superior to the control group with statistically significant difference(P < 0.01).Conclusion Modified radical mastectomy retaining medial pectoral nerve for I,Il breast cancer,not only can achieve the purpose of cure,but also effectively retains the postoperative chest function,which is of practical clinical significance in maintaining the quality of life of patients,safe and feasible,thus is worthy of clinical application.