乳腺癌改良根治术中保留肋间臂神经的临床意义

Clinical Significance of Retaining Intercostobrachial Nerve in Modified Radical Mastectomy

目的探讨乳腺癌改良根治术中腋淋巴结清扫时保留肋间臂神经(ICBN)的方法及临床意义。方法在61例乳腺癌改良根治术中腋淋巴结清扫时保留肋间臂神经26例,术后对保留肋间臂神经的26例患者上臂内侧及腋部皮肤感觉进行观察随访。结果保留肋间臂神经26例患者术后患侧上臂内侧及腋部皮肤感觉异常4例(15%),而切断切除肋间臂神经的35例患者术后感觉异常32例(91%)。随访6～24个月,2组均未见局部复发。结论乳腺癌改良根治术中腋淋巴结清扫时保留肋间臂神经是可行的,可以明显减少术后患侧上臂内侧及腋部皮肤感觉障碍的发生率,有助于改善患者的生活质量。

[Objective]To investigate the method and clinical significance of retaining intercostobrachial nerve（ICBN） in axillary lymph node dissection for breast cancer modified radical mastectomy.[Methods]ICBN of 26 cases was retained in axillary lymph node dissection of modified radical mastectomy on 61 breast cancer cases. The postoperative feelings of medial upper arm and the axillary skin of the 26 cases were observed in follow-up.[Results] Ipsilateral medial upper arm and the axillary skin of 4 cases （15%） in 26 patients with retaining of ICBN was paresthetic,while 32 cases （91%） in 35 patients with resection of ICBN felt paresthetic,Follow-up of 6~24 months,no local recurrence was observed.[Conclusion]The retaining ICBN in axillary lymph node dissection for breast cancer modified radical mastectomy is feasible,it can significantly reduce the incidence of postoperative paraesthesia of ipsilateral medial upper arm and axilla skin and help to improve the patients＇ quality of life.