成人尸体肋间臂神经解剖学特点及其临床意义

目的:为乳腺癌腋清扫术中保留肋间臂神经(JCBN)提供解剖学基础。方法:对5具成人尸体(2男3女)的10侧腋区进行了解剖,进行肋间臂神经观察和准确测量。并且对肋间臂神经周围组织结构及毗邻关系(血管、神经等)进行了仔细研究。结果:1)成人尸体的肋间臂神经直径较患者活体术中肋间臂神经直径为粗。2)成人尸体肋间臂神经的起止点以及与周围组织结构的距离和乳腺癌患者术中测量值基本相同。3)成人尸体肋间臂神经的形态学特点比较单一,均为单干分二支型,考虑原因是解剖尸体例数较少。4)由于解剖较彻底,比活体肋间臂神经分支复杂。结论:明确成人尸体JCBN解剖特点可指导乳腺癌腋清扫术中对肋间臂神经的保留,减少乳腺癌术后疼痛综合征(PMPS)的发生。

Anatomic Characteristics and Clinical Significance of Intercostobrachial Nerves of Adult Corpse

Objective: To provide anatomic basis for preservation of the intercostobrachial nerves (ICBN) during axillary node clearance for breast cancer. Methods: The ICBN and ambient tissues and structure were observed and measured by anatomizing 5 adult embalmed cadavers (10 sides). Result: a) The diameter of ICBN in adult embalmed cadavers was bigger than that of the patients during operation; b) The origination and destination of ICBN and the distance between ICBN and ambient tissues in adult embalmed cadavers were similar to those in the patients during operation; c) The form of ICBN in adult embalmed cadavers was simpler than in the patients during operation, which was single trunk with branches merely because of deficiency of adult embalmed cadavers and, d) The branches of ICBN in adult embalmed cadavers were more complicated than that of patients during operation due to anatomizing quite. Conclusion: Finding out the anatomic characteristic of the intercostobrachial nerves (ICBN) in adult's corpses can benifit to preserve them during axillary nodes clearance of breast cancer and can decrease the risk of PMPS.