保留胸前神经和肋间臂神经的乳腺癌手术效果观察

The effect of breast cancer operation preserving anterior thoracic nerve and intercostobrachial nerve

目的探讨与分析保留胸前神经(ATN)和肋间臂神经(ICBN)在乳腺癌手术的临床意义。方法选取2010年1月～2012年1月来我院就诊的90例乳腺癌患者为研究对象,将其分为两组,对照组不保留ATN和ICBN,研究组保留ATN和ICBN,比较两组术中与术后情况。结果两组手术时间比较差异有统计学意义(P<0.05)。两组患者术后6个月均无一例复发。研究组上肢水肿发生率为4.4%,对照组则为22.22%,比较具有统计学意义(P<0.05)。研究组术后上臂运动障碍发生率为4.4%,对照组则为31.1%,差异有统计学意义(P<0.01)。研究组术后感觉异常发生率为6.7%,对照组则为42.2%,比较具有统计学意义(P<0.01)。研究组重度胸大肌萎缩发生率为2.2%,对照组则为37.8%,经比较有统计学意义(P<0.01)。结论对乳腺癌手术患者保留ATN和ICBN,可降低上肢水肿、上臂运动障碍、感觉异常及胸大肌萎缩的发生,利于患者的恢复,值得临床推广。

Objective To investigate the clinical significance and analysis of preserving anterior thoracic nerve and intercostobrachial nerve during breast cancer operation. Methods A total of 90 cases of breast cancer in 2010 January to 2012 January in our hospital as the research object, divided into two groups,the control group does not preserve the anterior thoracic nerve and intercostobraehial nerve group, anterior thoracic nerve and intercostobrachial nerve preser- vation, compared two groups of intraoperative and postoperative. Results Operation time of two groups of comparison （P 〈0. 05）.Two groups of patients after 6 months showed no recurrence in 1 cases. Research group of upper limb edema was 4.4%, the control group was 22.22%, by ~omparison （P 〈 0.05）. Research group of postoperative up per arm movement disorder was 4.4%, the control group was 31.1%, by comparison（P 〈 0.01）. The abnormal rate of 6.7% research groups, the control group was 42.2%, by comparison （P 〈 0.01）. Research group of severe chest big muscle atrophy rate was 2.2%,the control group was 37.8%, by comparison（P 〈 0.01）. Conclusion Breast cancer patients with operation of preserving anterior thoracic nerve and intercostobrachial nerve, can reduce the edema of the upper limb, the upper arm movement disorders, sensory abnormalities and chest big muscle atrophy, conducive to the recovery of patients, is worthy of clinical application.