乳腺癌改良根治术中保留肋间臂神经的临床意义

【摘要】目的：探讨乳腺癌改良根治术中保留肋间臂神经的临床价值和临床应用的意义。方法：收集2006年02月至2012年02月在我院接受手术治疗的女性乳腺癌患者105例，均行乳腺癌简化根治性手术，根据患者乳腺癌分期、术中腋窝淋巴结状态，对其中32例患者保留肋间臂神经的临床资料进行系统回顾分析。结果：本组32例患者均采用Auchincloss法，保留肋间臂神经的乳腺癌改良根治术，其手术时间平均为150min;出血量平均约65ml;术中清扫淋巴结并经病理检出平均为16枚.术后对本组32例患者全部进行了6月－3年跟踪观察和随访，发现本组32例患者中，患侧上臂内侧及腋窝感觉异常的有4例，其中主要表现麻木、感觉缺失、袜套感、蚁行感3例，烧灼样疼痛1例，经局部理疗、营养神经药物治疗，多在1－2月内恢复；在随访期间未见局部复发和转移。结论：在乳腺癌改良根治术中，只要选择合适的病例，保留肋间臂神经是安全可行的，手术不复杂，术后也不会增加局部肿瘤复发和转移的危险性。乳腺癌改良根治术中保留肋间臂神经既可保存患侧上臂内侧及腋窝皮肤的感觉功能，又能提高乳腺癌患者术后的生活质量，具有一定的临床应用价值。

Clinical significance of preserving intercostobrachial nerve with modified radical mostectomy

【Abstract】 Objective To explore the clinic value and application significance of modified radical mastectomy preserving intercostobrachial nerve. Methods To collect from February 2006 to February 2012 in our hospital to accept the surgical treatment of women with breast cancer 105 cases, the 32 patiens preserving intercostobrachial nerve analysis of the clinical data system review analysis, including 32 cases with intercostobrachial nerve preserved and 73 cases without preservation. Sensation function in media arms was observed . Results After 6 months to 3 years of follow up visit 32cases with intercostobrachial nerve preserved had normal sensation in media arms(87.5%), and 4 cases had abnormal sense (12.5%) , while all 73 cases without preservation had abnormal sensation (100%). Did not see local recurrence and metastasis. Conclusions Modified radical mastectomy preserving intercostobrachial nerve can effectively prevent sensation disturbance and decrease the incidence of complication. It has no effect on radical cure of surgery and can improve the qulity of patients' life.