超声刀在保留肋间臂神经的乳腺癌改良根治术中的应用

Application of ultrasonic harmonic scalpel in preserving intercostobrachial nerve of modified radical mastectomy for breast cancer

目的探讨乳腺癌改良根治术中应用超声刀保留肋间臂神经的的价值。方法选取120例乳腺癌改良根治术患者,随机分为超声刀组和电刀组,每组60例,术中均保留肋间臂神经。对2组手术时间、出血量、淋巴结检出数目、术后患侧上臂感觉障碍进行比较分析。结果 2组患者的淋巴结检出数目差异无统计学意义(P>0.05)。超声刀组手术时间和出血量少于电刀组,差异有统计学意义(P<0.05)。超声刀组术后1个月患侧上臂感觉障碍发病率少于电刀组,差异有统计学意义(P<0.05)。术后3个月患侧上臂感觉障碍2组之间差异无统计学意义(P>0.05)。结论在保留肋间臂神经的乳腺癌改良根治术中,应用超声刀操作效率更高、更安全、术后近期并发上臂感觉障碍患者更少。

Objective To explore the value of application of ultrasonic harmonic scalpel in preserving intercostobrachial nerve of modified radical mastectomy for breast cancer.Methods Totally 120 cases with modified radical mastectomy for breast cancer were divided into the ultrasonic harmonic scalpel group and the electrocautery group,with 60 cases in each.The intercostobrachial nerve was preserved in operation.We compared the operation time,amount of bleeding,the number of lumph nodes and the lateral upper arm sensory disturbance after operation of the two groups.Results In two groups the number of lymph nodes detected was not statistically different.In the ultrasonic harmonic scalpel group,the operation time and amount of bleeding were less than that in the electrocautery group,the difference was statistically significant.In the first month after operation,the rate of sensory disturbance of the ultrasonic harmonic scalpel group was less than that of the electrocautery group,the difference was statistically significant.Meanwhile,there was no obvious difference in the third month.Conclusion The ultrasonic harmonic scalpel has obvious advantages in preserving intercostobrachial nerve of modified radical mastectomy for breast cancer.It is safer and more effective.And it has less upper arm sensory disturbance after operation for the near term.