乳腺癌腋窝淋巴结清扫术中保留肋间臂神经的临床研究

目的探讨乳腺癌腋窝淋巴结清扫术中保留肋间臂神经（Intercostobrachial nerve,ICBN）的临床价值。方法回顾性分析了新疆奎屯农七师医院及新疆肿瘤医院262例I、II期乳腺癌患者,随机分成两组（ICBN保留组112例及ICBN切除组150例）,比较两组术后的皮肤感觉、清扫淋巴结数目、手术时间、术中出血等临床资料。结果保留组在手术时间多于切除组;在术中出血量、清扫淋巴结个数与切除组相比差异无统计学意义（P〉0.05）;保留组在1、3、6月术后上臂内侧皮肤感觉障碍明显好于切除组,差异有统计学意义（P〈0.05）;在复发和转移方面与切除组相比差异无统计学意义,（P〉0.05）。结论乳腺癌腋窝淋巴结清扫术中保留ICBN,虽增加手术时间,但能减少术后患者上肢感觉异常,而不增加术后复发率。

The clinical study of preserving intercostbrachial nerve in axillary lymph node dissection of breast cancer

objective Discuss the clinical value Of preserving intercostobrachial nerve (ICBN) in axillary lymph node dissection Methods Retrospective analysis the 112 cases of ICBN retention group and 150 cases of ICBN resection group, To compare the effect of skin feel, the number of lymph node dissection, operative time, blood loss. Results The two groups in the number of lymph node dissection, blood loss,recurrence and metastasiswas was no significant difference(P>0.05);the surgery time of the Retention group was longer than the resection group(P<0.05);the skin feel after surgery 1,3,6 months of retention group in was significantly better than the resection group(P<0.05). Conclusion Preserving ICBN in axillary lymph node dissection, although increase the operative time, it can reduce postoperative upper limb paresthesia, and does not increase the recurrence rate .