改良乳腺癌根治术保留胸前神经的方法及临床意义

目的：探讨在改良乳腺癌根治术中保留胸前神经的方法和临床意义.方法：将68例拟行改良乳腺癌根治术的患者随机分为两组,保留胸前神经组和不保留胸前神经组各34例.保留胸前神经组手术时分开胸大肌暴露并保留胸内、外侧神经,不保留胸前神经组则不保留胸内、外侧神经.其余手术操作相同.术后12个月用彩超测量胸大肌厚度,并与对侧比较.结果：保留胸前神经组无重度胸大肌萎缩,不保留胸前神经组重度萎缩26例（76.5%）.经统计学检验,保留胸前神经组重度胸大肌萎缩情况较不保留胸前神经组明显减少（P＜0.01）.结论：改良乳腺癌根治术中保留胸前神经能减少术后胸大肌萎缩.

Method and clinical significance of preserving pectoral nervus in modified radical mastectomy of breast cancer

Objective: To study the method and clinical significance of preserving pectoral nervus in modified radical mastectomy. Methods: Sixty eight patients underwent modified radical mastectomy were divided into two groups randomly, the first group preserved medial and lateral pectoral nervus by transpectoral anterior approach(n=34),and the second group didn ' t preserved pectoral nervus(n=34). Twelve month after operation, ultrasonograph was used to detect the thickness of pectoralis major muscles, and compare with the other side. Results:No case in the first group and 26 cases(76.5%) in the second group suffered from postoperative atrophy of pectoralis major muscles(P<0.01). Conclusion: Preserve pectoral nervus in modified radical mastectomy can prevents pectoralis major muscle from atrophy.