保留肋间臂神经在乳腺癌腋窝淋巴结清扫术中的意义

Clinical value of preservation of the intercostobrachial nerve during axillary node dissection for breast cancer

目的:探讨保留肋间臂神经在早期乳腺癌腋窝淋巴结清扫术中的可行性及临床应用价值。方法:70例Ⅰ、Ⅱ期乳腺癌行腋窝淋巴结清扫术病人被分为两组,其中肋间臂神经保留组32例,肋间臂神经切除组38例。术后对病人上臂内侧感觉功能进行对比分析。结果:保留肋间臂神经与不保留肋间臂神经两组患者术后2周时,切除ICBN者36例均有上臂内侧和腋部皮肤麻木,其中12例有持续疼痛;而32例保留ICBN者中仅4例产生麻木,2例疼痛。结论:在早期乳腺癌(Ⅰ、Ⅱ期)改良根治术中施行保留肋间臂神经是可行的,它保存了患侧上臂内侧及腋部皮肤感觉功能,改善病人的生活质量,具有一定临床价值。

Objective： To study the feasibility and benefit of preserving intercostobrachial nerve （ICBN） during axillary lymph node dissection （ALND） for breast carcinoma. Methods： Seventy cases with stage Ⅰ-Ⅱ breast carcinoma during ALND were divided into two groups. Of them, ICBN was preserved in 32 eases, and severed in 38 cases. All patients were followed up. Results： Thirty six cases with ICBN severed group had pain or paresthesia of the skin of the upper medial arm and axilla after two weeks postoperation. And in ICBN preservation group, paresthesia occurred only in 4 cases and pain in 3 cases. No local recurrence was found during 1 to 5 year follow-up period. Conclusion： It is feasible to preserve ICBN during ALND for stage Ⅰ-Ⅱ breast carcinoma. Preservation of ICBN improves patient＇ s sensory deficit and quality of life.