乳腺癌Auchincloss改良根治术中保留肋间臂神经的临床研究  

Clinical research of preserving intercostobrachial nerve in auchincloss modified radical mastectomy of breast cancer

作　　者：陈壮威[1] 黄晓曦[1] 余养生[2] 王红玫[1] 彭翌[1] 王仁玉[1] 

机构地区：[1]福建省妇幼保健院乳腺科,福州350001 [2]福建中医药大学附属人民医院肿瘤外科

出　　处：《福建医药杂志》2016年第5期4-6,共3页Fujian Medical Journal

摘　　要：目的探讨乳腺癌Auchincloss改良根治术中腋窝淋巴结清扫时保留肋间臂神经(ICBN)对患者术后临床疗效的影响。方法对180例Ⅰ、Ⅱ、Ⅲa期乳腺癌患者临床资料进行回顾性分析,将其分为保留肋间臂神经组98例和切除肋间臂神经组82例。比较两组术后上臂内侧感觉异常等情况。结果接受Auchincloss手术后1、6个月,保留组患者患侧上臂内侧感觉异常发生率分别为17.3%、14.3%,显著低于切除组70.7%、47.6%,组间差异有统计学意义(P<0.01)。两组患者经过手术后36个月随访,复发或转移的发生率差异无统计学意义(P>0.05)。结论在Ⅰ、Ⅱ、Ⅲa期乳腺癌患者行Auchinclos手术中保留肋间臂神经,在不影响手术质量和预后的前提下,能够显著减轻患者术后上臂内侧感觉异常,提高生活质量。Objective To explore the clinical impact of preserved intercostobrachial nerve（ICBN）during axillary dissection for patients who underwent Auchincloss modified radical mastectomy of breast cancer.Methods Analyzed the clinical records of 180 patients of stage Ⅰ,Ⅱ,Ⅲa breast 1cancer who underwent Auchincloss modified radical mastectomy of breast cancer.Patients were divided into two groups,preserved intercostobrachial nerve group（n=98）and resected intercostobrachial nerve group（n=82）.The sensory function of ipsilateral medial upper arm were compared between the two groups.Results Patients with preserved intercostobrachial nerve group had a significantly lower morbidity of the sensory abnormalities of ipsilateral medial upper arm than those with resected intercostobrachial nerve group,when postoperative one month,six months（17.3%vs 70.7%,14.3%vs 47.6%,P〈0.01）.In a mean follow-up 36 months,there was no significant difference in tumor recurrence and distant metastasis between the two groups（P〉0.05）.Conclusion Providing that the operation quality and prognosis are not influenced,preserved intercostobrachial nerve may significantly decrease the morbidity of the postoperative sensory abnormalities of ipsilateral medial upper arm,and improve the quality of life in stageⅠ,Ⅱ,Ⅲapatients who underwent Auchincloss modified radical mastectomy of breast cancer.

关 键 词：乳腺癌 肋间臂神经 改良根治术 

分 类 号：R737.9[医药卫生—肿瘤]