保留肋间臂神经在乳腺癌腋窝淋巴结清扫术中的临床价值

Applied value of preservation of intercostobrachial nerve during axillary lymph node dissection for breast cancer

目的探讨保留肋间臂神经在乳腺癌腋窝淋巴结清扫术中的临床价值。方法选择Ⅰ、Ⅱ期乳腺瘤患者舳例，随机分为两组，实验组50例，在腋窝淋巴结清扫时完整保留肋间臂神经；对照组30例，采用常规方法切除不保留肋间臂神经。术后对两组患者进行随访，观察患侧腋窝及上臂感觉情况并作比较。结果术后3d、1个月、3个月及6个月实验组患侧腋窝及上臂感觉障碍发生率均小于对照组，且差异有统计学意义（P〈0．05）。结论在Ⅰ、Ⅱ期乳腺癌腋窝淋巴结清扫术中保留肋间臂神经，能够有效地防止患侧腋窝及上臂皮肤感觉障碍，改善患者生活质量，具有较高的临床价值。

Objective To evaluate the applied value of preservation of the intereostobrachial nerve（ ICBN） during axillary lymph node dissection for breast cancer. Methods Eighty cases of breast cancer with stage Ⅰ and stage Ⅱ were selected and randomly divided into experimental group（50 cases, complete preservation of ICBNs during axillary lymph node dissection）and control group（30 cases, dissection of ICBNs during axillary lymph node dissection）. The feelings of ipsilateral upper limbs and axillary area were evaluated and compared between the two groups after operation. Results The incidence of par- esthesia of ipsilateral upper limbs and armpit was significantly lower in experimental group than in control group at the 1 st,3rd and 6th month after operation（P 〈 0.01 ）. Conclusion Preservation of ICBN during axillary lymph node dissection for breast cancer can effectively reduce the incidence of paresthesia of ipsi- lateral upper limbs and armpit, improve the quality of life and have high applied value.