乳腺癌腔镜腋窝淋巴结清扫术保留肋间臂神经的临床研究  

Preservation of intercostobrachial nerve during endoscopic axillary lymph node dissection for breast cancer

作　　者：曾繁余[1] 张显岚[1] 张珊[1] 唐巍[1] 黄玥[1] 黄颖[1] 

机构地区：[1]桂林医学院附属医院普外二科,广西桂林541001

出　　处：《中国普通外科杂志》2013年第7期934-937,共4页China Journal of General Surgery

基　　金：广西壮族自治区卫生厅资助项目(Z2010289)

摘　　要：目的:探讨乳腺癌腔镜腋窝淋巴结清扫术(EALND)中保留肋间臂神经(ICBN)的方法及意义。方法:收集2010年4月—2012年9月98例行EALND的I,II期乳腺癌患者临床资料,将其中52例保留ICBN患者资料(保留组)与早期46例未保留ICBN患者资料(未保留组)进行对照分析。结果:保留组术后上臂皮肤感觉异常(麻木和/或疼痛)发生率为7.69%(4/52),未保留组为82.61%(38/46),两组差异有统计学意义(P<0.05)。未保留ICBN组中38例上臂皮肤感觉异常症状持续1年以上,保留组4例症状较未保留组轻微,其中3例3个月内症状完全缓解,1例6个月内症状完全缓解。结论:充分吸脂是乳腺癌EALND保留ICBN的关键,保留ICBN能够减少术后患侧上肢麻木和/或疼痛的发生,提高患者生活质量。Objective： To investigate the approach for the preservation of the intercostobrachial nerve（ICBN） during endoscopic axillary lymph node dissection（EALND） for breast cancer and its significance. Methods： The clinical data of 98 patients with stage I or II breast cancer undergoing EALND procedures during May 2010 to September 2012 were collected,and then the data from 52 patients with ICBN preservation（preservation group） were compared historically to those from 46 previously treated patients without ICBN preservation（non-preservation group）. Results： The post-mastectomy incidence of abnormal skin sensation（numbness and/or pain） in the upper arm in preservation group was 7.69%（4/52） and in non-preservation group was 82.61%（38/46） respectively,and difference between them had a statistical significance（P〈0.05）.The symptoms of abnormal skin sensation in the upper arm lasted for more than one year in the 38 cases in non-preservation group,and were considerably milder in the 4 cases in preservation group,among whom the symptoms were completely relieved in 3 cases within 3 months and within 6 months in 1 case. Conclusion： Sufficient liposuction is the key for preserving ICBN during EALND for breast cancer,and ICBN preservation can reduce the occurrence of upper arm numbness and/or pain after surgery and improve the patients＇ quality of life.

关 键 词：乳腺肿瘤 淋巴结切除术 肋间臂神经 

分 类 号：R737.9[医药卫生—肿瘤]