保留肋间臂神经在乳腺癌改良根治术中的应用效果

Application effect of preservation of intercostal brachial nerve in modified radical mastectomy for breast cancer

目的探讨保留肋间臂神经对乳腺癌改良根治术后感觉功能及预后的影响。方法选择2019年10月至2020年10月联勤保障部队第九〇〇医院莆田医疗区收治的84例女性乳腺癌患者,采用随机数字表法将其分为观察组(42例)与对照组(42例)。两组均行乳腺癌改良根治术治疗,观察组术中保留肋间臂神经,对照组术中不保留肋间臂神经,术后持续随访1年。比较两组的临床指标、感觉功能评分、并发症及预后情况。结果两组的手术时间、术中出血量、淋巴结清扫数量、并发症总发生率及复发率比较,差异无统计学意义(P>0.05);观察组的住院时间短于对照组,差异有统计学意义(P<0.05);两组术前的感觉功能障碍评分比较,差异无统计学意义(P>0.05);两组术后的感觉功能障碍评分均低于术前,但观察组术后不同时点的感觉功能障碍评分均高于对照组,差异有统计学意义(P<0.05)。结论乳腺癌改良根治术中保留肋间臂神经不会延长手术时间、增加手术创伤,对手术效果及预后无明显影响,且更利于患者术后感觉功能恢复,临床应用安全可靠。

Objective To investigate the influence of preservation of the intercostal brachial nerve on sensory function and prognosis after modified radical mastectomy for breast cancer.Methods A total of 84 female breast cancer patients admitted to the Putian Medical District of the 900th Hospital of the Joint Logistics Support Force from October 2019 to October 2020 were selected and divided into the observation group(42 cases)and the control group(42 cases)by random number table method.Both groups were treated with modified radical mastectomy for breast cancer.The intercostal brachial nerve was preserved in the observation group,while the intercostal brachial nerve was not preserved in the control group.The patients were followed up for 1 year.The clinical indicators,sensory function scores,complications and prognosis were compared between the two groups.Results There were no significant difference in operation time,in traoperative blood loss,number of lymph node dissection,the total incidence of complications and the recurrence rate between the two groups(P>0.05).The hospitalization time of the observation group was shorter than that of the control group,and the difference was statistically significant(P<0.05).There was no significant difference in the preoperative sensory dysfunction scores between the two groups(P>0.05).The scores of the postoperative sensory dysfunction in the two groups after surgery were lower than those before surgery,and the scores of the postoperative sensory dysfunction in the observation group after surgery were higher than those in the control group,while the differences were statistically significant(P<0.05).Conclusion Preserving the intercostals brachial nerve in modified radical mastectomy for breast cancer can not prolong the operation time and increase the surgical trauma,and has no significant effect on the surgical effect and prognosis,and is more conducive to the recovery of postoperative sensory function of patients.The clinical application is safe and reliable.