改良乳腺癌根治术中保留肋间臂神经的可行性评估

Evaluation on feasibility of preserving intercostobrachial nerve in preservation modified radical mastectomy for breast cancer

目的分析改良乳腺癌根治术中保留肋间臂神经的可行性。方法选取2018年3月至2019年10月上饶市妇幼保健院收治的84例乳腺癌患者作为研究对象,按照随机数字表法分为观察组与对照组,各42例。对照组改良乳腺癌根治术中不保留肋间臂神经,观察组改良乳腺癌根治术中保留肋间臂神经,比较两组手术整体情况、手术前后关节活动度、术后并发症发生率、感觉障碍发生率与生命质量。结果两组手术时间、术中出血量、淋巴结数目及住院时间比较差异无统计学意义。治疗后,两组肩关节前屈、肩关节后伸、肩关节外展活动度均小于治疗前,但观察组大于对照组,差异有统计学意义(P<0.05)。观察组术后并发症发生率与感觉障碍发生率均低于对照组,差异有统计学意义(P<0.05)。治疗后,两组生理状况、社会与家庭状况、情感状况、功能状况、乳腺癌附加状况评分及总分均高于治疗前,且观察组高于对照组,差异有统计学意义(P<0.05)。结论改良乳腺癌根治术中保留肋间臂神经能减少患者术后并发症与感觉障碍的发生,改善患者肩关节活动度,提高其生命质量,具有可行性,值得临床推广应用。

Objective To analyze the feasibility of preserving intercostobrachial nerve in preservation modified radical mastectomy for breast cancer.Methods 84 patients with breast cancer admitted to the Shangrao Maternal and Child Health Care Hospital from March 2018 to October 2019 were selected as the research subjects,and they were divided into the observation group and the control group according to the random number table method,with 42 cases in each group.The control group received modified radical mastectomy without intercostobrachial nerve preservation,and the observation group received modified radical mastectomy with intercostobrachial nerve preservation,the overall surgical status,joint range of motion before and after surgery,incidence of postoperative complications,sensory disorders and quality of life were compared between the two groups.Results There were no statistical differences in surgical time,intraoperative blood loss,the number of lymph nodes and hospitalization time between the two groups.After treatment,the ranges of motions of anterior flexion,posterior extension and abductor of shoulder of the two groups were smaller than before treatment,but the observation group were greater than the control group,the differences were statistically significant(P<0.05).The incidence rates of postoperative complications and incidence rates of sensory disorders in observation group were lower than those in the control group,the differences were statistically significant(P<0.05).After treatment,the scores of physiological status,social and family status,emotional status,functional status and breast cancer additional status and total score of the two groups were higher than before treatment,and the observation group was higher than the control group,the differences were statistically significant(P<0.05).Conclusion Preservation of intercostobrachial nerve in preservation modified radical mastectomy for breast cancer can reduce the occurrence of postoperative complications and sensory disorders,improve the shoulder range of motion and improve the quality of life of patients,which is feasible and worthy of clinical promotion and application.