乳腺癌Patey术后胸大肌功能评估的意义

目的：探讨乳腺癌Patey术后胸大肌功能及保留胸肩峰血管的意义。方法：对21例资料完整行Patey手术的乳腺癌患者（手术组），应用肌电图仪对术后胸大肌功能进行动态检测，并以对侧正常胸大肌做对照。结果：肌肉自发电位显示手术组1个月第1、2、3、4位点，术后3个月和12个月第2、3、4位点肌肉自发电位增多。MUP时限显示第3位点，术后第1、3、12个月增宽例数增多。肌肉募集型显示第2点在术后1个月单保留组混合相增多，干扰相减少；第3位点术后1、3、12个月干扰相病例减少，单纯相及混合相病例增多。MUP波幅显示术后1个月胸大肌各部分MUP低波幅例数多。第3个月双保留组第2位点、手术组第3位点、单保留组第4位点MUP低波幅例数多。第12个月第3位点手术组MUP低波幅例数明显低于对照组。结论：Patey术后胸大肌各部分均存在不同程度的功能损害，但这些损伤绝大多数可在1年内恢复正常。切除胸肩峰血管对手术后远期的胸大肌功能恢复没有明显影响。

Significance of the Pectoralis Major Muscle's Function after Patey's Operation

To explore the significance of the pectoralis major muscle's function after Patey's operation and keeping thoracoacromial vessels. Twenty_one cases of breast cancer after patey's operation were examined by electromyogram to evaluate the function of pectoralis major muscle.The function of non_operated pectoralis major muscle was compared as control. Compared with control group,spontaneous electrical activity increased at 1,2,3,4 position point 1 month after operation and 2,3,4 position point in 3 months and 12 months after operation in surgery group.The normal cases of MUP period at second position point in two surgical groups decreased in 1 and 3 months after operation. The normal cases decreased but many cases increased at third position point in two surgical groups.The mixed form increased but the disturbance form decreased at collecting form of electrical activity second position point in 1 month in single keeping group.The disturbance form cases decreased but simplex form and mixed form cases increased at third position point in two operated group in 1,3,12 months postoperatively.The cases of MUP wave decreasement increased at 1,2,3,4 position point in two surgical groups in 1 month postoperatively.MUP were decreasement increased at second position point in both keeping group,at third position point in operated two group and at fourth position point in single keeping group in 3 months postoperatively. And MUP wave decreasement increased at third position point in two surgical groups in 12 months.Conclusion]The Patey operation can make reversible injury to pectoralis major muscle.Removing thoracoacromial vessels does not effect remarkably the function of pectoralis major muscle.