保留肋间臂神经乳腺癌腋窝淋巴结清扫术(附38例报告)  

Preservation of intercostobrachial nerves in axillary lymph node dissec tion for breast cancer(33 case reports affiliated)

作　　者：李成华[1] 王矛[1] 庄严[1] 沈铁骁[1] 

机构地区：[1]安徽省蚌埠市第三人民医院普外科,233000

出　　处：《淮海医药》2005年第3期182-183,共2页Journal of Huaihai Medicine

摘　　要：目的　探讨保留肋间臂神经在乳腺癌腋淋巴结清扫术中的可行性及临床应用价值。方法　1999年～2 0 0 4年在5 7例、期乳腺癌腋淋巴结清扫术中施行保留肋间臂神经,其中完整保留肋间臂神经38例,切除肋间臂神经19例。术后对病人进行观察并随访。结果　保留肋间臂神经38例中术后患侧上臂内侧及腋部皮肤感觉正常33例(86 .8% ) ,感觉异常5例(13.2 % ) ;而切除肋间臂神经的19例病人均有感觉异常。随访1～5年,5 7例中2例远处转移死亡。结论　在 、期乳腺癌腋淋巴结清扫术中保留肋间臂神经是可行的,它保存了患侧上臂内侧及腋部皮肤的感觉功能,有利于改善病人术后的生活质量,具有一定的临床应用价值。Objective To discuss t he feasibility and clinical value of pre serving intercostobrachial nerve(ICBN) i n axillary lymph node dissection for br east neoplasma.Methods Preservatio n of ICBN in axillary lymph node cleara nce was performed between 1989 and 2004 in 57 patients with stage Ⅰ or Ⅱ breast carcinoma ICBN was preserved completely in 38 cases,and dissected in 19 cases.Al l patients were followed up after operat ions.Results Among the 38 patients with ICBN preserved,33 patients(86.8% ) had normal sensation of the skin of up per medial arm and axilla,while paresthe sia occurred in only 5 cases(13.2%).By c ontrast all the 19 patients with ICBN di ssected had paresthesia.Two cases died o f metastasis within the follow up period .Conclusion It is feasible to pres erve ICBN in axillary lymph node dissect ion for stage Ⅰ or Ⅱ breast carcinoma.It keeps the normal sensory functions of t he skin of upper medial arm and axilla a nd improves the life quality of the pati ents after operations.

关 键 词：保留肋间臂神经 腋窝淋巴结清扫术 腋淋巴结清扫 临床应用价值 Ⅱ期乳腺癌 上臂内侧 感觉异常 2004年 1999年 皮肤感觉 远处转移 感觉功能 生活质量 术中 病人 术后 切除 随访 腋部 患侧 

分 类 号：R737.9[医药卫生—肿瘤] R658.2[医药卫生—临床医学]