乳腺癌手术中保留胸前神经、肋间臂神经的临床意义  

Clinical significance of preserving ATN and ICBN during operation for breast cancer

作　　者：李金茂[1] 鲁建国[1] 何显力[1] 贾国战[1] 蔡斌[1] 

机构地区：[1]第四军医大学唐都医院普外科,陕西西安710038

出　　处：《现代肿瘤医学》2010年第5期929-931,共3页Journal of Modern Oncology

摘　　要：目的:总结乳腺癌手术中保留胸前神经(ATN)和肋间臂神经(ICBN)的方法及临床意义。方法:回顾我院近10年间乳腺癌行保乳术及改根术共982例患者病历资料,保留ATN及ICBN者799例,切断ATN及ICBN183例,术后随访观察胸大小肌萎缩情况和患侧腋窝、上臂内侧的感觉异常情况。结果:保留ATN及ICBN患者患侧腋部及上臂内侧皮肤感觉正常占81.1%(648/799),感觉异常18.9%(151/799)且多在2-3个月内恢复,术后3个月胸肌无明显萎缩,外形良好,患肢负重运动良好;而切断ATN及ICBN183例患者仅36例(19.7%)感觉正常,147例(80.3%)有不同程度的感觉异常,主要表现患侧腋窝、上臂内侧及肩胛下部位的疼痛、麻木、酸胀、蚁行感和烧灼感等,术后3个月患侧胸肌不同程度萎缩及上肢活动障碍、功能减退。结论:乳腺癌手术中保留ATN及ICBN是可行的,可以有效减少患侧腋部及上肢感觉异常和胸肌萎缩的发生率,改善乳腺癌患者的术后生活质量。Objective：To summarize the method and clinical significance of preserving ATN and ICBN during op- eration for breast cancer. Methods：Total of 982 eases with breast cancer in recent 10 years were reviewed. 799 eases were performed by preserving ATN and ICBN, 183 cases were performed by no preserving ATN and ICBN. The pa- tients were followed - up postoperatively. Results ： Among the patients performed by preserving ATN and ICBN, skin sensation of armpit and upper ann were normal in 81.1% （648/799） ,18.9% （151/799） patients were abnormal, but most of them were restored in 2 - 3 months. Among the patients performed by no preserving ATN and ICBN, skin sensation were normal only in 36 cases （19.7%）, 147 cases （80. 3% ） were abnormal at different degree. Conclu- sion：Preserving ATN and ICBN during operation for breast cancer is feasible,life quality of the patients after opera- tion is improved.

关 键 词：乳腺肿瘤 肋间臂神经 胸前神经 淋巴结清扫术 改良根治术 

分 类 号：R734.2[医药卫生—肿瘤]