保留肋间臂神经和胸前神经在乳腺癌改良根治术中的效果评价

Evaluation of the Effect of Retaining Intercostal Nerve and Thoracic Nerve in Modified Radical Mastectomy for Breast Cancer

目的:探讨保留胸前神经和肋间臂神经的乳腺癌改良根治术治疗乳腺癌的临床效果及意义。方法:课题研究对象为2010年1月-2014年1月到笔者所在医院进行治疗的160例浸润性乳腺癌患者,依据随机数字表法将其分为对照组(87例)和观察组(73例)。对照组采用经典的乳腺癌改良根治术,观察组采用保留肋间臂神经和胸前神经的乳腺癌改良根治术,比较两组患者术中及术后恢复情况。结果:观察组手术时间明显长于对照组[(78.55±10.32)min vs(63.76±9.80)min],差异有统计学意义(t=4.734,P<0.05)。而淋巴结清扫数量和术中出血量组间比较,差异无统计学意义(P>0.05)。术后12个月随访结果示,对照组的并发症发生率明显高于观察组(35.63%vs 6.85%),差异有统计学意义(字2=8.102,P<0.05)。结论:保留胸前神经和肋间臂神经的乳腺癌改良根治术对患侧上肢运动及感觉功能影响较小,可显著降低术后并发症发生率,适宜推广应用。

Objective： To explore the clinical effect and significance of modified radical mastectomy for breast cancer with thoracic nerve and intercostal nerve.Method： 160 patients with invasive breast cancer who underwent treatment from January 2010 to January 2014 were divided into control group（87 cases） and observation group（73 cases） according to the random number table method.The control group was treated with classical modified radical mastectomy.The observation group was treated with modified radical mastectomy with retained intercostal nerve and thoracic nerve.The operation and postoperative recovery were compared between the two groups.Result： The operation time of the observation group was significantly longer than that of the control group[（78.55 ± 10.32）rain vs （63.76 ± 9.80）min], the difference was statistically significant（t=4.734, P〈0.05）.Compared with the number of lymph node dissection and intraoperative blood loss between the two groups, there were no significant differences（P〉0.05）.The results of 12 months follow-up showed that the incidence of adverse events in the control group was significantly higher than that in the observation granp[（35.63%） vs （6.85%）], the 2 difference was statistically slgnlficant（χ^2=8.102, P〈0.05）.Conclusion： The modified radical mastectomy of retaining thoracic nerve and intercostal nerve has little effect on upper limb movement and sensory function, which can significantly reduce the incidence of postoperative complications and is suitable for popularization and application.