保留乳头的功能性乳癌根治术应用解剖学研究  

Research of Applied Anatomy of Adenocarcinoma Radical Cure Technique Reserved Nipple

作　　者：李国楼[1] 孙正凯[1] 宋守洪[1] 菅凤国[1] 刘述霞[1] 刘文杰[1] 曹凤俊[1] 黄东力[1] 

机构地区：[1]昌邑市人民医院,山东昌邑261300

出　　处：《潍坊医学院学报》2005年第2期97-99,共3页Acta Academiae Medicinae Weifang

摘　　要：目的通过对支配胸肌神经及肋间臂神经的解剖学研究,设计一个合理的乳癌手术方式。方法利用10%的福尔马林固定的成年女性尸体10具(20侧),常规解剖方法解剖出胸上神经、胸内神经、胸外神经及肋间臂神经。临床行60例乳腺癌根治术(实验组、对照组各30例),实验组完全保留胸神经、肋间臂神经及乳头,术后检查两组病人胸肌的厚度、患侧上肢的感觉、肌力,并进行对照分析。结果临床实验组:患侧胸大肌厚度和患侧上臂内收肌力与健侧比较差异无显著性(P>0.01)。实验组术后发生上肢感觉障碍率6.7%、对照组63.9%.二者比较差异有显著性(P<0.01)。结论该术式对保护上肢功能,胸部美学及提高病人的生存质量, 有非常重要的意义,是一种治疗I,Ⅱ期乳腺癌合理有效的术式。Objective Through research of anatomy of nerves dominating pectoral muscle and intercostobrachial nerves, In design a reasonable mode of operation of curing mastocarcinoma. Methods Utilizing 10 adult female corpora (20 sides) which were perfused by 10% formalin, superior pectoral nerve,medial pectoral nerves,and lateral pectoral nerve and intercostobrachial nerves were revealed. In clinical research, 60 cases of patients were implemented for mastocarcinoma radical cure technique (each experiment group and control group included 30 cases, separately). In operation, direct current was used to stimulate thoracic nerves and confirm the relationship of domination.The sense of wrong upper limb of the patients of two groups and the thickness of Bilateral Pectoralis major were examined and analyzed. Results Clinical experiment group: there was no significant difference comparing the thickness of the pectoralis major muscle and the muscle strength of the adductor and the angle of adduction of the wrong side with the good side ( P > 0.01) . 6.7 percent of patients in the experiment group happened to the postoperative sensory disability of the upper limbs. In contrast, the control group, 63.9 percent. The difference of the results between the two groups was significant ( P < 0.01) . Conclusion This model of operation can protect the upper limb function,and has value of aesthetics of the brisket,and improve the quality of survive of the patient .

关 键 词：乳腺 乳癌 胸肌 切除术 神经 

分 类 号：R655.8[医药卫生—外科学]