保留肋间臂神经在乳腺癌腋淋巴结清扫术中的临床应用

Clinical application of preserving intercostobrachial nerve during axillary lymph node dissection for breast cancer

目的探讨保留肋间臂神经（ICBN）在乳腺癌腋淋巴结清扫术中的可行性及临床应用价值。方法1999～2003年322例Ⅰ、Ⅱ期乳腺癌的腋淋巴结清扫术中，保留ICBN102例，切除ICBN220例，术后对病人观察并随访。结果保留肋间臂神经102例中病人术后患侧上肢内侧及腋部皮肤感觉异常9例（8．8％），而切除肋间臂神经的220例病人术后感染异常192例（87％）、随访2～5年，未见局部复发。结论Ⅰ、Ⅱ期乳腺癌患者腋淋巴结清扫术中保留ICBN是可行的，能提高患者术后生存质量。

Objective To evaluate the feasibility and clinical value of preserving intereostobraehial nerve （ICBN） during axillaw lymph node dissection for breast neoplasms. Methods Axillary lymph node clearance was performed during 1999 to 2003 in 322 patients with stage Ⅰ or Ⅱ breast eareinoma,ICBN was preserved in 102 cases,dissected in 220 eases. All patients were followed up after operations. Results 102 patients with ICBN being preserved,9 patients （8.8%） had paresthesia of the skin of upper medial arm and axilla, while 192 （87%） in 220 patients with ICBN dissected had paresthesia. There was no local recurrence in any patient within the follow up period. Conclusion It is feasible to preserve ICBN during axillary lymph node dissection for stage Ⅰ or Ⅱ breast carcinoma. It can improve the patients life quality after operations.