保留肋间臂神经在乳腺癌腋淋巴结清扫术中的临床意义  

Clinical value of preservation of the intercostobrachial nerve during axillary node clearance for breast cancer

作　　者：余启文[1] 苏兴桂[1] 罗光辉[1] 周宏[1] 宋涛[1] 

机构地区：[1]广东省江门市新会区人民医院外科,广东江门529100

出　　处：《广东医学院学报》2005年第3期253-254,共2页Journal of Guangdong Medical College

摘　　要：目的:分析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:1998年1月～2004年6月在138例～期乳腺癌的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98例,切除40例。术后对患者进行随访观察。结果:保留肋间臂神经98例中,术后患侧上臂内侧及腋部皮肤感觉正常90例(91.8%),感觉异常8例(8.1%),而切除肋间臂神经40例中均有感觉异常。比较两者的感觉异常率差异有显著性(χ2=105.61,P<0.001)。随访1～5a,138例均未见复发。结论:在乳腺癌腋窝淋巴结清扫术中,保留肋间臂神经是可行的,它既保存了患侧上臂内侧及腋部皮肤的感觉功能,又改善了患者术后生活质量,具有一定临床价值。Objective: To study the feasibility and benefit of preserving intercostobrachial nerve (ICBN) during axillary lymph node dissection (ALND) for breast carcinoma. Methods: ICBN preservation was performed on 138 patients with stage I-Ⅲ breast carcinoma during ALND between January 1998 and June 2004. Of them, ICBN was preserved in 98 cases, and severed in 40 cases. All patients were followed up. Results: The incidence of paresthesia was significantly lower in ICBN preservation group than that in ICBN sacrifice group (8.1% vs 100%, P<0.001). No local recurrence was found during 1 to 5 year follow-up period. Conclusion: It is feasible to preserve ICBN during ALND for breast carcinoma. Preservation of ICBN improves patient's sensory deficit and quality of life.

关 键 词：乳腺肿瘤/外科学 肋间臂神经 淋巴结切除术 

分 类 号：R737.9[医药卫生—肿瘤]