保留肋间臂神经在乳腺癌改良根治术中的应用

Preservation of intercostobrachial nerve during modified radical mastectomy

目的探讨保留肋间臂神经在乳腺癌改良根治术中的临床应用价值。方法我院2005年1月—2009年1月行乳腺癌改良根治术共372例,其中保留肋间臂神经9 3例(保留组),未保留肋间臂神经2 7 9例(切除组),术后均进行1年随访观察。结果保留组术后1、3、12个月患侧上臂内侧及腋窝皮肤感觉异常的发生率均明显低于切除组,两者差异显著(P<0.0 5);而术后3、6、1 2个月腋窝局部复发率两组相比无显著性差异(P>0.0 5)。结论乳腺癌改良根治术中保留肋间臂神经有利于减少术后患侧上臂内侧及腋窝皮肤感觉异常的发生率,改善术后患者的生活质量,且不影响手术效果,值得临床推广应用。

Objective To study the clinical value of preservation of intercostobrachial nerve（ICBN） during modified radical mastectomy.Methods From January 2005 to January 2009,372 cases of modified radical mastectomy were performed in our hospital,among them,ICBN was preserved in 93 cases（preserve group）,and not preserved ICBN in 279 cases（resected group） All of the patients were followed-up for a year.Results At 1,3 and 12 months after surgery,the incidence of ipsilateral medial upper arm and axillary paresthesias in ICBN preserve group was significantly lower than that in the resection group,and the difference was significant（P0.05）;at 3,6,12 months after surgery local axillary recurrence rate in the two groups showed no significant difference（P0.05）.Conclusions Preservation of ICBN in modified radical mastectomy has the advantage of decrease in ipsilaleral arm and armpit paresthesia with improvement in quality of life after surgery,and does not affect surgical outcome.It is worthy of widespread clinical application.