乳腺癌改良根治术中保留肋间臂神经的临床价值

Modified radical mastectomy preserving intercostobrachial nerve in clinical application

目的探讨早期（Ⅰ、Ⅱ期）乳腺癌改良根治术中保留肋间臂神经的临床价值。方法回顾性分析62例行早期乳腺癌改良根治术患者的临床资料，以术中完整保留肋间臂神经46例患者作为观察组，术中切除肋间臂神经16例患者作为对照组，对比分析两组术后上臂内侧及腋部皮肤感觉异常发生情况及乳腺癌复发情况。结果62例均行乳腺癌改良根治术，均临床治愈出院。观察组上臂内侧及腋窝皮肤感觉异常5例（10．9％），明显低于对照组的16例（100．0％）（χ2=19．27，P〈0．05）。平均随访1年，观察组中上臂皮肤感党异常患者5例，在术后1-3个月内恢复；对照组感觉异常均未恢复正常；两组均未发现肿瘤局部复发或远处转移。结论在乳腺癌改良根治术中保留肋间臂神经是可行的，可明显减少术后患侧上臂内侧及腋部皮肤感觉异常发生率，改善患者术后生活质量。

Objective To explore the early（ I , II ） in modified radical mastectomy of breast cancer clinical value of preserving intercostobrachial nerve. Methods A retrospective analysis of 62 cases of early breast cancer patients with the clinical data, on intraoperative complete preservation of the intercostobrachial nerve in 46 cases as the observation group ,intraoperative resected intercostobrachial nerve in 16 cases as control group ,comparative analysis of the two groups after the upper medial arm and axilla skin paresthesia and breast cancer recurrence. Results All 62 cases underwent modified radical mastectomy of breast cancer, all patients were cured. The observation group upper medial arm and axillary skin sensory abnormalities in 5 cases （ 10.9% ）, significantly lower than the control group of 16 cases （100%） （X： = 19.27, P 〈 0.05 ）. A mean follow-up of 1 year, the observation group in upper arm skin party abnormalities in patients with 5 cases, after 1 - 3 mongths recovery ; control group of sensory abnormalities were not returned to normal;the two groups were not found in local tumor recurrence or distant metastasis. Conclusion In modified radical mastectomy of breast cancer reserving intercostobrachial nerve was feasible, and could significantly reduce the postoperative lateral medial arm and axilla skin feeling abnormal rate, and improve the quality of life in patients.