保留胸前神经及肋间臂神经的乳腺癌手术方式的疗效及对术后生活质量的影响

目的观察保留胸前神经（ATN）及肋间臂神经（ICBN）的乳腺癌手术方式治疗效果，探讨对术后生活质量的影响。 方法选取2014年1月至2016年1月德阳市人民医院诊治的78例乳腺癌患者，按随机数字表法分为观察组（39例）与对照组（39例）。观察组行保留ATN、ICBN手术方式治疗，对照组行切断ATN、ICBN手术方式治疗。观察比较两组患者术中及预后情况、并发症发生情况及术后生活质量情况。 结果两组在术中出血量、手术时间、淋巴结清扫数比较的差异均无统计学意义。观察组上臂感觉障碍合并运动障碍并发症发生率均低于对照组（χ²=9.974、11.692，均P<0.01），对照组发生重度胸大肌萎缩22例，发生率显著高于观察组（χ²=25.652，P<0.01）。观察组术后FACT-B各领域分值及量表总分值等生命质量量化结果均显著低于对照组，生活质量更高（均P<0.01）。随访24~48个月，两组均无局部复发、远处转移、死亡病例。 结论对早、中期乳腺癌患者实施保留ATN、ICBN的手术方式行之有效，能显著降低乳腺癌根治术后并发症，提高患者术后生活质量。

Effect of surgical treatment on breast cancer preserving anterior thoracic nerve and intercostobrachial nerve and its influence on postoperative quality of life

ObjectiveTo investigate the effect of surgical treatment of breast cancer reserving anterior thoracic nerve (ATN) and intercostobrachial nerve (ICBN), and to explore the influence on quality of life after operation. MethodsSeventy-eight cases of breast cancer admitted in Sichuan Province Deyang People’s Hospital from January 2014 to January 2016 were selected and divided into observation group (39 cases) and control group (39 cases) according to the random number table. The observation group was treated with ATN and ICBN preserved, and the control group ATN and ICBN divided. The intraoperative and postoperative prognosis, complications and postoperative quality of life were observed and compared between the two groups. ResultsThere was no statistically significant difference between the two groups with intraoperative bleeding volume, operation time and lymph nodes clearance. The incidence of complications in the observation group was significantly lower than that in the control group (χ²=9.974, 11.692, 25.652, all P<0.01). The FACT-B score and the total score of quality of life in the observation group after the operation were significantly lower than those in the control group (all P<0.01). There were no local recurrence, distant metastasis or death in the two groups during the follow-up period of 24-48 months. ConclusionIt’s feasible and effective for the early and middle stages of breast cancer patients retaining ATN and ICBN, which can significantly reduce the incidence of complications after radical mastectomy for breast cancer, improve the quality of life of patients.