保留胸前神经及肋间臂神经的根治术对早期乳腺癌患者的疗效分析

Analysis of Curative Effect of Preserving Anterior Thoracic Nerve and Intercostobrachial Nerve for Early Breast Cancer Patients

目的 研究保留胸前神经、肋间臂神经的根治术对早期乳腺癌患者的疗效。方法 选取早期乳腺癌患者82例,采用随机数字表法,将患者划分为A组与B组,各41例。B组采用切断胸前神经、肋间臂神经的根治术治疗,A组采用保留胸前神经及肋间臂神经的根治术治疗。对比两组术中情况、术后情况、免疫球蛋白G(IgG)、T淋巴细胞亚群(CD3^(+))、胸肌萎缩情况、上臂与腋窝区感觉功能障碍状况及并发症发生状况。结果 A组术中出血量较B组少(P<0.05);A组术后引流时间较B组短,术后总引流量较少(P<0.05);与B组比较,术后1W,A组IgG、CD3^(+)水平较高(P<0.05);A组胸肌萎缩发生率[9.76%(4/41)]较B组[26.83%(11/41)]低(P<0.05);A组上臂疼痛、腋窝区皮肤感觉异常发生率[4.88%(2/41)、7.32%(3/41)]较B组[19.51%(8/41)、24.39%(10/41)]低(P<0.05);A组并发症发生率[4.88%(2/41)]与B组[9.76%(4/41)]对比无显著差异(P>0.05)。结论 采用保留胸前神经及肋间臂神经的根治术应用于早期乳腺癌,可提高免疫功能,降低胸肌萎缩发生率,减少术中出血量、上臂疼痛、腋窝区皮肤感觉异常发生状况,促进术后恢复,存在安全性。

Objective To study the curative effect of radical resection with preservation of anterior thoracic nerve and intercostobrachial nerve on early breast cancer patients.Methods 82 patients with early breast cancer were selected and divided into group A and group B,with 41 cases in each.Group B underwent radical surgery by cutting off the anterior thoracic nerve and intercostobrachial nerve,while group A underwent radical surgery by preserving the anterior thoracic nerve and intercostobrachial nerve.Compared the intraoperative and postoperative conditions,immunoglobulin G(IgG),T lymphocyte subpopulations(CD3^(+)),chest muscle atrophy,sensory dysfunction in the upper arm and armpit areas,and incidence of complications between the two groups.Results The intraoperative bleeding volume in Group A was lower than that in group B(P<0.05);The postoperative drainage time in Group A was shorter than that in group B,and the total postoperative drainage flow was lower(P<0.05);Compared with group B,the levels of IgG and CD3^(+)in group A were higher after 1 week of surgery(P<0.05);The incidence of chest muscle atrophy in group A [9.76%(4/41)] was lower than that in group B [26.83%(11/41)](P<0.05);The incidence of upper arm pain and abnormal skin sensation in the axillary area in Group A [4.88%(2/41),7.32%(3/41)] was lower than that in group B [19.51%(8/41),24.39%(10/41)](P<0.05);There was no significant difference in the incidence of complications between group A [4.88%(2/41)] and group B [9.76%(4/41)](P>0.05).Conclusion Radical operation with preservation of anterior thoracic nerve and intercostobrachial nerve for early breast cancer can improve immune function,reduce the incidence of pectoral muscle atrophy,reduce intraoperative bleeding,upper arm pain,and the occurrence of abnormal skin sensation in the axillary region,and promote postoperative recovery.It is safe.