保留肋间臂神经在乳腺癌手术中的应用及临床价值

Methods of preserving intercostobrachial nerve during breast cancer surgery and its clinical value

目的探讨及验证乳腺癌腋窝淋巴结清扫术中保留肋间臂神经的方法和临床价值。方法选择68例Ⅰ、Ⅱ期乳腺癌患者,分为2组,即保留组(31例)行乳腺癌腋窝淋巴结切除术时保留肋间臂神经,切断组(37例)行常规手术时切除肋间臂神经,对2组进行观察随访。结果保留组及切断组术后患侧发生上肢感觉障碍的发生率分别为9.7%(3/31)及73%(27/37),差异有统计学意义(P<0.05),经24个月随访均未发生肿瘤局部复发。结论早期乳腺癌行腋窝淋巴结清扫术保留肋间臂神经可以明显减少术后患侧上肢感觉障碍。

Objective To study the methods and the clinical value of preserving intercostobrachial nerve during the axillary lymph nodes excision in breast cancer surgery. Methods Sixty eight cases of stage Ⅰand Ⅱ breast cancer patients were divided into re served group and resection group. The intercostobrachial nerves were preserved in reserved group and not in resection group. Both groups were found no recurrence within 24months after surgery by following up. Results The postoperative arm sensory disturbance was 9.7 % （3/31 ） in the reserved group, which was significantly different from that of the resection group 73 % （27/37） （x2 = 27.41, P 〈 0.05）. Conclusion Preserving intercostobrachial nerves maysignificantly decrease the postoperative morbidity of arm sensory disturb ance during axillary excision of stageⅠand Ⅱbreast cancer patients.