保留肋间臂神经在乳腺癌改良根治术中的应用

Application of Intercostobrachial Nerve Preservation in Modified Radical Mastectomy

目的:探讨保留肋间臂神经在乳腺癌改良根治术中的临床应用价值。方法:对132例不同期乳腺癌病人行手术治疗。将其随机分为两组:保留组(60例)行腋窝清扫术时保留ICBN,对照组(72例)行腋窝清扫术时常规切除ICBN,两组病人术后均按乳腺癌治疗指南治疗。结果:在皮肤障碍发生率方面:保留组术后1个月(10.0%)、3个月(3.3%)、12个月(1.7%)均显著低于对照组;在疼痛发生率方面:保留组术后1个月(5.0%)、3个月(1.7%)、12个月(1.7%)均显著低于对照组,组间差异均P<0.05。保留组术后4年复发率(3.3%)略高于对照组(1.7%),5年复发率(3.3%)略低于对照组(6.7%),无显著性差异(P>0.05)。结论:保留肋间臂神经改善了乳腺癌改良根治术后皮肤感觉障碍及疼痛情况,有助于保有患者感觉功能,值得临床推广应用。

Objective：To study the clinical application value of intercostobrachial nerve preservation in modified radical mastectomy.Methods：132cases of breast cancer patients in different period were given surgical treatment,and randomly divided into two groups：preservation group（60cases）received axillary surgery with retaining ICBN,the control group（72cases）ICBN received conventional resection without retaining ICBN.Patients of two groups were given postoperative treatment based on breast cancer treatment guidelines,then observed the results.Results：The incidence of skin disorders of preservation group after 1months（10%）,3months（3.3% months）,12（1.7%）were significantly lower than those of control group;The incidence of pain of preservation group after 1 months（5%）,3（1.7%）,12 months（1.7%）were significantly lower than those of control group.The differences between the two groups were statistically significant（P〈0.05）.After 4years,the recurrence rate of preservation group（3.3%）was slightly higher than that of control group（1.7%）,and after 5year,the recurrence rate of preservation group（3.3%）was slightly lower than that of control group（6.7%）,which the difference was statistically significant（P〉0.05）.Conclusion：Preservation of the intercostobrachial nerve in modified radical mastectomy can improve skin sensory disturbance and pain solution after operation,and help to maintain sensory function of patients,which is worthy of clinical application.