乳腺癌改良根治术中保留胸前神经和肋间臂神经对患者生存率及复发率的影响分析

Effects of Preserving Anterior Thoracic Nerve and Intercostobrachial Nerve in Modified Radical Mastectomy on Survival Rate and Recurrence Rate of Patients

目的研究分析乳腺癌改良根治术中保留胸前神经和肋间臂神经对患者生存率及复发率的影响。方法运用随机数表法将本院2016年5月-2018年7月诊治的70例乳腺癌患者分为观察组与对照组,各35例。观察组为保留胸前神经和肋间臂神经的乳腺癌改良根治术,对照组为不保留胸前神经和肋间臂神经的传统乳腺癌根治术。比较两组患者手术相关指标、生存率、复发率、转移率、并发症发生情况。结果观察组手术时间显著短于对照组(P<0.05),术中出血量、淋巴结清扫数量两组相比无统计学意义(P>0.05);观察组的复发率显著低于对照组(P<0.05),生存率和转移部位腋窝、骨、肺两组相比无统计学意义(P>0.05);观察组腋窝疼痛、上臂水肿、胸肌萎缩、上臂运动障碍、感染发生数低于对照组(P>0.05)。结论乳腺癌改良根治术中保留胸前神经和肋间臂神经术后并发症少,可以控制肿瘤的复发率和转移率,临床应用良好。

Objective To study the effects of preserving anterior thoracic nerve and intercostobrachial nerve in modified radical mastectomy on survival rate and recurrence rate of patients.Methods 70 patients with breast cancer diagnosed and treated in the hospital from May 2016 to July 2018 were divided into observation group and control group by the random number table method with 35 cases in each group.The observation group was treated with modified radical mastectomy with preservation of anterior thoracic nerve and intercostobrachial nerve while the control group was treated with conventional radical mastectomy without preserving anterior thoracic nerve and intercostobrachial nerve.The operation related indexes,survival rate,recurrence rate,metastasis rate and incidence of complications were compared between the two groups.Results The operation time of the observation group was significantly shorter than that of the control group(P<0.05).There was no significant difference in the amount of intraoperative blood loss or number of lymph nodes removed between the two groups(P>0.05).The recurrence rate of the observation group was significantly lower than that of the control group(P<0.05).There was no statistically significant difference in survival rate or metastases in the armpit,bone or lung(P>0.05).The incidence rates of axillary pain,upper arm edema,chest muscle atrophy,upper arm movement disorder and infection in the observation group were lower than those in the control group(P>0.05).Conclusion Complications are few after modified radical mastectomy with preservation of anterior thoracic nerve and intercostobrachial nerve.The operation can control the recurrence rate and metastasis rate of tumors.The clinical application is good.