乳腺癌腋窝淋巴结清除术保留肋间臂神经的临床观察

CLINICAL OBSERVATION BREAST CANCER AXILLARY LYMPH NODE DISSECTION AND RESERVING INTERCOSTOBRACHIAL NERVE

目的：探讨乳腺癌腋窝淋巴结清除术（ALND）中保留肋闻臂神经（ICBN）的可行性及意义。方法：抽选我院91例Ⅰ、Ⅱ期乳癌患者，根据在ALND术中ICBN保留与否分为对照组（n=46例，切除ICBN）和观察组（n=45例，保留ICBN），比较两组淋巴清扫量、手术时间以及术后2周、3、6个月患侧皮肤感觉障碍的随访差异。结果：两组患者淋巴清扫量、手术时间比较差异无显著性（P〈0．05）；术后2周，3、6个月皮肤感觉障碍随访结果比较差异显著（P〈0．05）；随访1-2年两组均未出现肿瘤复发病例。结论：乳腺癌ALND术中保留ICBN，可显著降低术后患侧上臂发生皮肤感觉障碍的几率，且对手术总体治井静关不产硅影响佶解脯糜箍产．

Objective：To explore the feasibility and significance, of the breast cancer axillary lymph node dissection （ALND） in the preservation of the intercostobrachial nerve （ICBN） Method： in our hospital I , II breast cancer patients were selected 91 cases, ac- cording to the ALND intraoperative ICBN retention or not and divided into control group （ n = 46 cases, resection of ICBN） and obser- vation group （ n = 45 cases, retention of ICBN）, compared two groups of lymph node dissection, operation time and postoperative 2 week, and 3 the 6 - month ipsilateral skin sensory follow - up the difference. Results：Two groups of lymph node dissection, operation time had no significant difference （ P 〈 O. 05 ） ; 2 weeks after operation, 3, 6 months esthesiodetmia follow - up results are significantly different （ P 〈 0.05） ; 1 - 2 years follow - up of two groups had no cases of recurrence. Conclusion： ALND ICBN reserved for breast cancer patients, can significantly reduce the risk of postoperative lateral upper arm skin sensory disturbance, and does not affect the o- verall operation curative effect, which is worth the clinical promotion.