保留胸前神经和肋间臂神经的改良式乳腺癌根治术的应用效果分析

Application of Modified Radical Mastectomy with Preservation of Anterior Thoracic Nerve and Intercostobrachial Nerve

目的探讨保留胸前神经和肋间臂神经的改良式乳腺癌根治术的应用效果。方法随机选择该院2013年1月-2017年12月至该院行乳腺癌治疗的患者100例并通过随机数字法将患者分为观察组和对照组,各50例,对照组患者行乳腺癌标准根治术,观察组患者行保留胸前神经和肋间臂神经的改良乳腺根治术。观察两组患者手术相关指标、术后并发症发生情况,随访患者3年,比较两组患者远期疗效。结果观察组患者术中出血量、术后引流量、术后引流时间均明显低于对照组(t=17.634,P=0.000;t=33.797,P=0.000;t=7.851,P=0.000),观察组患者术后并发症发生率为8.00%,明显低于对照组24.00%,差异有统计学意义(χ^2=4.762,P=0.029),两组患者局部复发率、腋淋巴结复发率、远处转移率、3年存活率、OS、PFS对比,差异无统计学意义(χ^2=0.444,P=0.505;χ^2=0.154,P=0.695;χ^2=0.298,P=0.585;χ^2=0.657,P=0.418;t=0.311,P=0.757;t=0.693,P=0.490)。结论保留胸前神经和肋间臂神经的改良式乳腺癌根治术能够明显减轻手术对患者损伤,减少术后并发症发生率,且能够保证患者的远期疗效,具有很好的临床应用前景。

Objective To discuss the effect of modified radical mastectomy with preservation of anterior thoracic nerve and intercostobrachial nerve. Methods 100 patients with breast cancer treated in the hospital from January 2013 to December 2017 were randomly selected and divided into observation group and control group by random number method. The control group received standard radical mastectomy for breast cancer, while the observation group received modified radical mastectomy with preservation of anterior thoracic nerve and intercostobrachial nerve. The operation related indexes and complications of the two groups were observed. The patients were followed up for 3 years, and the long-term efficacy of the two groups was compared. Results The blood volume, drainage volume and drainage time in the observation group were significantly lower than those in the control group(t=17.634, P=0.000;t=33.797,P=0.000;t=7.851, P=0.000). The incidence of complications in the observation group was 8.00%, which was significantly lower than that in the control group(24.00%).There were statistically significant differences between the two groups(χ^2=4.762, P =0.029). The local recurrence rate,axillary lymph node recurrence rate, distant metastasis rate, 3-year survival rate, OS, PFS,and the difference was not statistically significant(χ^2=0.444, P=0.505;χ^2=0.154, P=0.695;χ^2=0.298, P=0.585;χ^2=0.657, P=0.418;t=0.311, P=0.757;t=0.693, P =0.490). Conclusion Modified radical mastectomy with preservation of anterior thoracic nerve and intercostobrachial nerve can significantly reduce the surgical injury to patients, reduce the incidence of complications, and ensure the long-term efficacy of patients. It has good clinical application prospects.