保留肋间臂神经的乳腺癌改良根治术46例临床研究

目的:探讨乳腺癌患者行乳腺癌改良根治术中保留肋间臂神经(Intercostobrachial nerve,ICBN)的可行性及临床意义。方法:在86例Ⅰ、Ⅱ期乳腺癌患者中,行改良根治术时完整保留ICBN 46例,切除40例。比较两组患者术后上臂内侧及腋窝部皮肤感觉功能。结果:保留ICBN组46例,腋窝及上臂内侧皮肤感觉异常6例(13.04%)。切除ICBN组40,腋窝及上臂内侧皮肤感觉异常30例(75.00%)。两组间差异有统计学意义(P<0.05)。随访3～72个月,两组均无肿瘤局部复发和远处转移。结论:保留肋间臂神经在Ⅰ、Ⅱ期乳腺癌改良根治术中是安全可行的,能有效保留患者上臂内侧及腋窝皮肤感觉功能,提高患者术后生活质量。

The reporter of 46 cases about preserving intercostobrachial nerve in modified radicalmastectomy

Objective To investigate the feasibility and clinical significance of reserving intercostobrachial nerve（ICBN） during the modified radicalmastectomy.Methods 86 breast cancer cases with stageⅠorⅡ were underwent modified radicalmastectomy.The ICBN was preserved completely in 46 cases,and was resected in 40 cases.The sensation of medial upper arms and axilla was observed.Results In the group of reserving ICBN,6 patients（13.04%） had abnormal sensation on the skin of medial upper arms and axilla after operation.The patients of non-reserved ICBN,20 patients（75.00%） had abnormal sensation on the skin of medial upper arms and axilla after operation.and the difference was significant（P 0.05）;No recurrencew as found during 3 to 72 months of follow-up in both groups.Conclusion Reserving ICBN in modified radical mastectomy for the patients with breast cancer,which is safe and has certa in clinica l significance,can obviously reduce the incidence of pain syndrome and improve the life quality of the patients after operations.