乳腺癌改良根治术保留肋间壁神经的临床观察及意义

Clinical observation and significance of preserving intercostobrachial nerve in modified radical mastectomy

目的探讨观察乳腺癌改良根治术中保留肋间臂神经的可行性及临床意义。方法选择拟行乳腺癌改良根治术的乳腺癌患者50例,随机分为两组,实验组26例术时保留肋间臂神经,对照组24例术中切除肋间臂神经。术后对两组患者上臂内侧感觉功能进行随访观察。结果实验组患者术后上臂感觉障碍发生率为11.5%,而对照组高达54.2%,两组比较差异有显著性,两组术后复发率等指标差异无显著性。结论对乳腺癌需行腋淋巴结清扫术的患者,术中保留肋间臂神经可明显减少术后患侧上臂内侧感觉障碍的发生率,不增加手术并发症的发生,不影响手术的根治性,有助于提高患者的生活质量。

Objective To study the feasibility and clinical significance of preserving intercostobrachial nerve in modified radical mastectomy. Methods Fifty patients who would be operated with modified radical mastectomy were randomly divided into experimental group （n = 26 ） and control group（ n = 24 ）. The intereostobrachial nerve was preserved in the experimental group and not in the control group. Sensory function of the medial part of upper arm was examined after the operation. Results The postoperation morbidity of arm sensory disturbance was 11.5% in the experimental group, which was significantly lower than that of the control group（ 54.2% ）. No difference was noted in the recurrence rate between the two groups. Conclusion Preserving intereostobrachial nerve in axillary lymph node dissection for the patients with breast cancer can decrease the incidence of sensory disturbance on the skin of medial part of upper arm. It does not increase occurrence of operation complications and can enhance the life quality of the patients after operation.