保留肋间臂神经在Ⅰ、Ⅱ期乳腺癌手术中的临床价值  

Clinical Value of Reserving Intercostobrachial Nerve in Stage Ⅰ,Ⅱ Breast Cancer Operation

作　　者：陆兆贵[1] 张锡贵[1] 章五一[1] 

机构地区：[1]广东省农垦中心医院,广东湛江524002

出　　处：《临床医学工程》2013年第10期1245-1246,共2页Clinical Medicine & Engineering

摘　　要：目的探讨保留肋间臂神经在乳腺癌改良根治术中的方法及临床价值。方法回顾性分析86例行乳腺癌改良根治术的Ⅰ、Ⅱ期乳腺癌患者，随机分为两组，观察组和对照组各43例，观察组术中保留肋间臂神经，对照组术中切除肋间臂神经，进行12～36个月的随访观察，比较两组患者术后上臂内侧和腋窝皮肤感觉功能、术后皮下积液、皮瓣坏死及腋窝局部复发情况。结果观察组患者术后患侧上臂内侧及腋窝皮肤感觉异常4例（9．3％），对照组患者感觉异常41例（9．5．3％），观察组明显优于对照组患者（P〈0．01）。两组患者手术时间、术中出血、术后并发症及腋窝复发情况比较，差异无统计学意义（P〉O．05）。结论保留肋间臂神经在Ⅰ、Ⅱ期乳腺癌患者改良根治术中可以减少上臂、腋窝皮肤感觉异常的发生，提高了患者术后的生活质量，值得临床推广应用。Objective To explore the methods and clinical value of reserving intercostobrachial nerve in modified radical mastectomy for breast cancer. Methods 86 patients of breast cancer at stage Ⅰ、Ⅱ undergoing modified radical mastectomy were randomly divided into observation group （43 cases） and control group （43 cases）. The intercostobrachial nerves were preserved in observation group, while resected in control group. The postoperative sensory functions of interior upper arms and axilla skin, seroma, flap necrosis and axillary local recurrence were tracked for 12 - 36 months and compared between the two groups. Results 4 patients （9.3%） of the observation group and 41 patients （95.3%） of the control group had abnormal sensation at the interior upper arms and axilla skin; the observation group was better than control group （P 〈0.01）. The operation time, intraoperative bleeding and postoperative complications and axillary relapse between the two groups had no statistical significance （P 〉0.05）. Conclusions Reserving intercostobrachial nerve in modified radical mastectomy for breast cancer at stage Ⅰ、Ⅱ can reduce the occurrence of abnormal sensory and impairment in skins of upper and axillary, and improve the postoperative quality of life, so it is worthy of clinical application and popularization.

关 键 词：肋间臂神经 乳腺癌 改良根治术 临床价值 

分 类 号：R737.9[医药卫生—肿瘤]