乳腺癌改良根治术中保留肋间臂神经的临床研究

Clinical study of intercostobrachial nerve reservation in radical resection of breast cancer

目的探讨在乳腺癌改良根治术中保留肋间臂神经(ICBN)的可行性及其临床意义。方法在56例乳腺癌改良根治术中施行保留肋间臂神经手术,其中完整保留肋间臂神经38例,切除肋间臂神经18例。结果保留肋间臂神经38例与切除肋间臂神经18例术后患侧上臂内侧及腋部皮肤感觉异常比较,差异有统计学意义(P<0.01)。术后平均随访16个月,56例均未见局部复发。结论在乳腺癌改良根治术中通过手术技巧的改进,保留肋间臂神经是可行的,亦是必要的,它保存了患侧上臂内侧及腋部皮肤的感觉功能,提高患者生活质量。

Objective To investigate the clinical significance of intercostobrachial nerve reservation in radical resection of breast cancer. Methods 56 patients were under-went radical resection of breast cancer, the intercostobrachial nerve was reserved in 38 cases, and resected in 18 cases. Results Comparing esthesiodermia of internal upper arm and axilla in two groups：the intercostobrachial nerve was reserved （n = 38 ） in experimental group, and resected in control group （n = 18 ） , The differences between two groups were statistically significant（P〈0. 01）. There were no focal tumor recurrence after a mean 16 flow-up. Conclusion Preserving inter-costobrachial nerve is feasible and necessary, with the improvement of surgical skills in radical resection. It keeped normal skin sensory function of internal upper arm. and enhanced the quality of life after operation.