乳腺癌改良根治术中保留肋间臂神经的临床意义

目的:探究乳腺癌改良根治术中保留肋间臂神经对预后改善的价值,讨论该项操作用于乳腺癌治疗的临床意义。方法:选择我院2000年3月～2010年6月行改良根治术的89例乳腺癌患者进行回顾性分析,其中47例完整保留肋间臂神经(观察组),42例切除(对照组),对两组患者术后患侧上臂内侧及腋窝区皮肤感觉状况进行跟踪随访。结果:经过术后12个月随访,观察组感觉正常41例(87.23%),异常6例(12.77%);对照组感觉正常22例(52.38%),异常20例(47.62%),组间对比差异具有统计学意义(P<0.05)。结论:乳腺癌改良根治术肋间臂神经的保留可以预防乳腺癌改良根治术后上臂及腋窝感觉障碍的发生,且并不增加复发的风险,值得作为一项标准纳入乳腺癌改良根治手术。

The clinical significance of preserving intercostobrachial nerve in modified radical mastectomy

Objective: To investigate the clinical value preserving intercostobarchial nerve in modified radical mastectomy,especially its prognostic value for the treatment of breast cancer.Methods: Data of 89 cases of breast cancer admitted to our hospital from Mar.2009 to Jun.2010 were reviewed,of which 47 cases(observation group) were subjected to the radical mastectomy with preservation of intercostobarchial nerve while 42 cases(control group) were subjected to radical mastectomy without preservation of intercostobarchial nerve.The postoperational sensory functions of interior upper arms and armpits were tracked and compared between the two groups.Results: After 12 months of follow-up,41(87.23%) cases of the observation group showed normal sensory functions;while 6(12.77%) showed abnormal sensory functions;the corresponding data of the control group was 22(52.38%) and 20(47.62%) showing significant difference between the two groups(P<0.05).Conclusions:Radical mastectomy with preservation of intercostobarchial nerve can prevent the sensory disorders of interior upper arms and armpits without increasing the risk of recurrence.This operation is worthy of adopting as a norm in modified radical mastectomy.