乳腺癌手术保留腋鞘的临床意义探讨  

Clinical significance of retaining axillary sheath in breast cancer surgery

作　　者：黄黎明[1] 田井琦[1] 陈巍[1] 章蔚[1] 

机构地区：[1]浙江省绍兴市人民医院乳腺甲状腺外科,312000

出　　处：《中国医师进修杂志》2010年第18期25-27,共3页Chinese Journal of Postgraduates of Medicine

摘　　要：目的 探讨乳腺癌手术腋窝淋巴结清扫时保留腋鞘的临床意义.方法 回顾性分析2004年1月至2008年1月施行并获得12个月随访的402例乳腺癌改良根治术患者的临床资料.按腋窝淋巴结清扫时保留腋鞘与否分为A、B两组,A组243例,B组159例.术后对两组患者腋窝皮下积液和上肢水肿情况进行观察随访.结果 A、B两组术后顽固性腋窝皮下积液发生率分别为5.3%（13/243）、10.7%（17/159）,两组比较差异有统计学意义（P＜0.05） 术后1、6、12个月上肢水肿严重程度与发生率分别比较,A组均显著低于B组（P＜0.01）.结论 乳腺癌改良根治术腋窝淋巴结清扫时探查腋鞘内或其周围无明显肿大和可疑转移淋巴结的情况下,保留腋鞘能够有效降低术后顽固性腋窝皮下积液和上肢水肿的严重程度与发生率,提高患者的生存质量.Objective To investigate the clinical significance of retaining axillary sheath in axillary lymph node dissection of breast cancer surgery. Methods Four hundred and two patients received modified radical mastectomy from January 2004 to January 2008 and followed up for 12 months were retrospectively analyzed. They were divided into two groups （group A and B） according to whether retaining axillary sheath in operation. Compared the morbidities of axillary effusion and edema of upper limbs between two groups. Results The morbidity of axillary effusion after operation in group A （5.3%, 13/243 ） was lower than that in group B （10.7%,17/159）（P〈0.05）. Based on the data followed up for 1,6, 12 months after operation, the morbidity of edema of upper limbs in group A were also lower than those in group B （P 〈0.01）. Conclusion Retaining axillary sheath when there is no evidence of lymph node metastasis in axillary sheath, will prominently lower the morbidities of axillary effusion and edema of upper limbs,improve the life quality of patients.

关 键 词：乳腺肿瘤 水肿 腋鞘 

分 类 号：R737.9[医药卫生—肿瘤]