保留肋间臂神经在乳腺癌改良根治术中的临床意义

目的分析保留肋间臂神经在乳腺癌改良根治术中的临床效果。方法乳腺癌患者80例,随机分为观察组与对照组,每组各40例。观察组行保留肋间臂神经手术,对照组则将肋间臂神经同时清扫,比较两组患者手术时间、清扫淋巴结数量、术中出血量以及并发症发生率。随访两组患者术后上臂感觉障碍及复发转移情况。结果两组患者手术时间、手术清扫淋巴结数量及术中出血量比较,差异无统计学意义(P0.05)。观察组并发症发生率为12.50%,对照组率为15.00%,两组比较,差异无统计学意义(P0.05)。观察组术后1周上臂感觉障碍为10.00%,术后1个月为5.00%,术后3个月为2.50%,术后6个月为2.50%,术后12个月无。对照组分别为52.50%、47.50%、45.50%、37.50%和27.50%。观察组术后上臂感觉障碍发生率明显低于对照组(P0.05)。随访1年,两组患者均无复发及转移。结论在乳腺癌改良根治术中保留肋间臂神经可以有效地降低术后患侧上臂感觉障碍发生率。

Clinical significance of preserving the intercostobrachial nerve in modified radical mastectomy for breast cancer

Objective To analyze and discuss the effects of preserving the intercostobrachial nerve(ICBN)in modified radical mastectomy for breast cancer. Methods A total of 80 patients with breast cancer were randomly divided into the observation group and control group(n = 40 in each). The ICBN in the observation group were reserved and it was removed in the control group. Operation time,the number of lymph nodes,blood loss and complication rates were compared between groups. Two groups of patients were followed up for abnormal sensory function and relapse and metastasis. Results There were no differences in the operation time,the number of dissected lymph nodes and blood loss(P > 0. 05). There was no difference in complication rate(12. 50% vs 15. 00% )between the observation group and control group(P > 0. 05). There were significant differences in the incidence of abnormal sensory function at the first week(10. 00% vs 52. 50% ),the first month(5. 00% vs 47. 50% ),the third month(2. 50%vs 45. 50% ),the sixth month(2. 50% vs 37. 50% ),and the twelfth month(0. 00% vs 27. 50% )after op-eration between the observation group and control group(P < 0. 05). During the one-year follow-up peri-od,there was no relapse or metastasis. Conclusion Preserving ICBN in modified radical mastectomy can effectively reduce the incidence of abnormal sensory function of the upper limb.