乳腺癌根治术中保留肋间臂神经的临床意义

Clinical significance of preserving intercostobrachial nerve during breast cancer operation

目的:探讨乳腺癌腋窝淋巴结清扫术中保留肋间臂神经(intercostobrachial nerve,ICBN)的临床意义。方法:将61例Ⅰ、Ⅱ期乳腺癌患者随机分为对照组31例,术时常规切除ICBN,治疗组30例行腋窝淋巴结清扫术时保留ICBN。术后均按乳腺癌规范治疗,并行康复运动,严密随访观察。结果:治疗组和对照组术后1、3、6个月上臂内侧感觉障碍发生率分别为16.7%、6.7%、6.7%和77.4%、64.5%、58.1%,差异均有统计学意义(P<0.01),经1～4年随访均无局部复发。结论:Ⅰ、Ⅱ期乳腺癌患者行腋窝淋巴结清扫时常规保留ICBN,可以明显减少术后患侧上肢感觉障碍的发生,提高生活质量。

Objective：To study the clinical significance of preserving intercostobrachial nerve（ICBN） during the axillary lymph nodes excision in breast cancer operation. Methods：Sixty-one patients with stages Ⅰ and Ⅱ breast cancer were divided into treatment group（30 cases） and control group（31 cases）.ICBN was regularly resected in operation in control group,ICBN was preserved in axillary lymph node dissection operation in treatment group.Patients in both groups were treated as breast cancer regular therapy and followed rehabiliation exercise after operation. Results：The incidece of abnormal sense on medial upper arm in one,three and six months after operation was 16.7%,6.7%,and 6.7%,respectively,in treatment group,which was significantly lower than that 77.4%,64.5%,and 58.1%,respectively,in control group（P0.01）. Conclusions：Preserving ICBN in the axillary lymph nodes excision in breast cancer operation can reduce the incidence of abnormal sense on medial upper arm and improve life quality.