乳腺癌腋窝淋巴结清除术中保留肋间臂神经的影响研究

Study of influence of retaining intercostobrachial nerve in axillary lymph node dissection operation for breast cancer

目的研究乳腺癌腋窝淋巴结清除术中保留肋间臂神经的方法和效果,为更好地治疗乳腺癌提供参考。方法选择2008年2月-2014年3月本院收治的乳腺癌患者80例为研究对象,将其随机分为两组。对照组使用临床常规手术方法,在腋窝淋巴结清除过程中不保留肋间臂神经;实验组在腋窝淋巴结清除术中保留肋间臂神经,比较两组患者的手术时间、出血量、皮肤感觉异常率、疼痛率等。结果两组患者的手术时间、出血量差异无统计学意义（P〉0.05）;实验组的皮肤感觉异常率、疼痛率低于对照组（P〈0.05）;两组患者手术后半年的复发率和远处转移率差异无统计学意义（P〉0.05）。结论使用乳腺癌腋窝淋巴结清除术给予保留肋间臂神经的效果更好,可改善患者术后上臂功能异常等情况,提高其术后生活质量,且不会影响手术效果,值得应用。

Objective To analyze the method and effect of retaining intercostobrachial nerve in axillary lymph node dissection operation for breast cancer to provide reference for a better treatment of breast cancer. Methods 80 patients with breast cancer admitted into our hospital from February 2008 to March 2014 were selected as research subjects,and they were randomly divided into two groups.The control group was given a clinical regular surgical method which did not retain the intercostobracial nerve in axillary lymph node dissection operation while experiment group was given the surgery which retained the intercostobracial nerve in axillary lymph node dissection operation.Operation time,bleeding amount,the rate of paresthesia of skin and pain rate and so on between two groups was compared respectively. Results There was no statistical difference of operation time,bleeding amount between two groups（P〉0.05）;the rate of paresthesia of skin and pain rate in experimental group was lower than that of control group respectively（P〈0.05）.There was no statistical difference of relapse rate and distant metastasis rate after half a year followed-up between two groups（P〉0.05）. Conclusion Retaining intercostobrachial nerve in axillary lymph node dissection operation for breast cancer has better effect and can improve condition such as abnormal function of upper arms after surgery for patients,and improve postoperative life quality and it can not affect the surgical efficacy.It is worthy of application.