不同手术治疗Ⅰ～Ⅱ期乳腺癌对保留肋间臂神经的影响比较

Comparison of the effects of different surgical treatments for stage Ⅰ～Ⅱ breast cancer on the preservation of intercostobrachial nerve

目的 探究不同手术方法治疗Ⅰ~Ⅱ期乳腺癌对保留肋间臂神经( ICBN))的疗效。方法 回顾性分析2016年1月至2018年1月72例早期乳腺癌患者,根据术式不同分为保乳组( n =38)与根治组( n =34),保乳组患者采取保乳手术治疗,根治组患者进行改良根治术治疗。采用SPSS19.0软件进行统计分析,围术期相关指标和术后乳腺功能评分等采用(±s)描述,独立t检验;术后并发症发生率及术后肢体感觉情况采用χ 2检验分析,P <0.05差异有统计学意义。结果 保乳组患者的手术时间、术中出血量、总引流量等围手术指标均明显少于根治组( P <0.05),淋巴结清扫数量两组差异无统计学意义( P >0.05);保乳组患者的并发症总发生率为10.5%,显著低于根治组患者的29.4%( P <0.05);保乳组患者的术后灼痛、麻木、疼痛、感觉减退等肢体感觉情况和乳腺功能评分明显好于根治组( P <0.05)。结论 保乳手术对Ⅰ~Ⅱ期乳腺癌患者的疗效良好,能有效保留患者的ICBN,改善其乳腺功能,值得临床应用。

Objective To investigate the effect of different surgical treatments for stage Ⅰ~Ⅱ breast cancer on the preservation of intercostobrachial nerve (ICBN). Methods 72 patients with early breast cancer treated in our hospital from January 2016 to January 2018 were retrospectively analyzed. The patients were divided into breast-conserving group ( n =38) and radical group ( n =34) according to different surgical methods. Among them, patients in the breast-preserving group were treated with breast-conserving surgery, while those in the radical group were treated with modified radical mastectomy. The data were analyzed by SPSS19.0 software. The perioperative related indicators and postoperative mammary gland function scores were described by (±s) and compared with independent t test. The postoperative complication rate and postoperative limb sensation were described by (n,%), and compared with χ 2 test. The difference was statistically significant when P <0.05. Results Compared with the radical group, the perioperative indexes such as operation time, intraoperative blood loss and total drainage volume were significantly lower in the breast-preserving group ( P <0.05), but there was no significant difference in the number of lymph node dissection between the two groups( P >0.05). In addition, the total incidence of complications in the breast-preserving group was 10.5%, which was significantly lower than that in the radical group (29.4%)( P <0.05). The incidences of postoperative burning pain, numbness, pain, sensory loss and no sensory feelings of the patients in the breast-preserving group were significantly lower than those in the radical group ( P <0.05). The scores of breast function in the postoperative breast-preserving group were significantly better than those in the radical group ( P <0.05). Conclusion Breast-conserving surgery has a good therapeutic effect on patients with stage Ⅰ~Ⅱ breast cancer, which can effectively preserve the patient’s ICBN and improve its mammary gland function, which is worthy of clinical recommendation.