保留肋间臂神经在乳腺癌改良根治术中的临床意义

目的探讨乳腺癌改良根治术中保留肋间臂神经（intercostobrachial，ICBN）的临床意义。方法在62例Ⅰ～Ⅱ期乳腺癌患者中，行改良根治术时完整保留肋间臂神经32例，切除30例。术后1个月对两组患者患侧上臂内侧和腋窝区的皮肤感觉功能进行检查。结果保留ICBN的病例中，术后患侧上臂及腋窝区皮肤感觉正常24例（75％），感觉异常8例（25％），而切除ICBN的病例中术后感觉正常6例（20％），感觉异常24例（80％）.两组上臂内侧和腋窝区的皮肤感觉异常比较，差异有统计学意义（P〈0．05）经随访1年无一例出现肿瘤局部复发。结论乳腺癌改良根治术中保留肋间臂神经可以预防术后上臂及腋窝区感觉异常的发生，不增加局部复发的风险，应成为乳腺癌改良根治术的标准组成部分。

Clinical value of preserving intercostobrachial nerve in modified radical mastectomy

Objective To study the value of preserving intercostobrachial nerve( ICBN )in modified radical mastectomy. Methods Sixty-two breast cancer cases with stage Ⅰ or Ⅱ were underwent improved radical re-section. The ICBN was preserved completely in 32 case, and was resected in 30. Sensory function of the medial arm and auxiliary fossa were examined 1 month after operation. Results In the 32 of ICBN preserving patients, there were 24 ( 75% ) of skin euesthesia and 8 ( 25% ) of paraesthesia in the medial upper arm and auxiliary. But in the 30 cases of ICNB cutting, there were 6( 20% )of sin euesthesia and 24 ( 80% ) of paraesthesia. And they had significant difference ( P＜ 0.05 ).No local failure occurred. Conclusion It is feasible to preserve ICNB in auxiliary lymph node dissection for stage Ⅰ or Ⅱ breast carcinoma. The normal sensory function of the skin of upper medical arm and auxiliary are conserved and the life quality of the patients is improved after modified radical operations.