溶脂辅助在乳腺癌腋窝淋巴结清扫术中保留肋间臂神经的应用

目的:探讨溶脂辅助在乳腺癌腋窝淋巴结清扫术中保留肋间臂神经的应用效果。方法:选取68例Ⅰ~Ⅲa期女性乳腺癌患者作为研究对象,所有患者均接受乳腺癌根治术或乳腺癌改良根治术治疗,根据术中是否应用溶脂辅助将上述患者分为观察组(36例)与对照组(32例),观察组在溶脂辅助下行乳腺癌腋窝淋巴结清扫术治疗,对照组行常规保留肋间臂神经腋窝淋巴结清扫术治疗,对比分析两组患者的疗效。结果:(1)观察组手术时间、术中出血量显著低于对照组,淋巴结清除数显著多于对照组,差异均有统计学意义(P<0.05)。(2)组内不同时间点术后引流量比较:观察组与对照组引流量在术后第1、2、3、4天之间比较差异均有统计学意义(P<0.05)。不同时间点两组患者之间引流量比较:术后第1、2、3、4天,观察组引流量均显著低于对照组(P<0.05)。(3)观察组患肢疼痛、提肩运动障碍、患肢水肿、皮下积液等并发症发生率显著低于对照组(P<0.05)。(4)观察组患侧上臂感觉异常率显著低于对照组(P<0.05)。结论:溶脂辅助在乳腺癌腋窝淋巴结清扫术中保留肋间臂神经的应用效果良好,具有手术操作简便、淋巴结清除数多,术中出血量、术后引流量少,并发症发生率低,脂肪溶解过程中未产生不良反应等优点。

The fat soluble auxiliary in breast cancer axillary lymph node dissection with preservation of intercostobrachial nerve during operation

Objective:To investigate the application effect of fat soluble auxiliary on preserving intercostobrachial nerve during axillary lymph node dissection in breast cancer.Methods:68 cases of 1-3 a phase breast cancer patients underwent radical operation in the treatment of breast modified radical mastectomy or breast cancer,according to the intraoperative application of fat soluble the patients were divided into observation group (n=36) and control group (n=32),observation group fat soluble auxiliary,surgery for axillary lymph node dissection for breast cancer treatment,the control group underwent conventional preservation of the intercostobrachial nerve in axillary lymph node dissection for treatment,compared the effects of two groups of patients.Results:The operation time and blood loss of the observation group were significantly lower than those of the control group,and the number of lymph node clearance was significantly higher than that of the control group,the difference was statistically significant (P<0.05).The difference of postoperative drainage volume in different time points,the difference between the observation group and the control group was 1 d,2 d,3 d and 4 d after operation (P<0.05).Compared with the control group,the flow rate of the patients in the observation group was significantly lower than that of the control group at different time points:1 d,2 d,3 d and 4 d after operation (P<0.05).In the observation group,the incidence of limb pain,shoulder movement disorder,limb edema,subcutaneous hydrops and other complications were significantly lower than those in the control group (P<0.05).The observation group ipsilateral arm sensory abnormality rate was significantly lower than the control group (P<0.05).Conclusion:The fat soluble auxiliary sweep retention effect of intercostobrachial nerve during the operation of good breast cancer axillary lymph nodewas simple with more lymph node dissection,low intraoperative blood loss and postoperative drainage volume,low complication rate,adverse reactions fat dissolving process.