乳腺癌根治术保留胸前神经及肋间臂神经的可行性分析  

Feasibility of anterior thoracic and intercostobrachial nerve reservation in radical mastectomy for breast cancer

作　　者：姜庆贺[1] 王爱芝[1] 徐彬[1] 

机构地区：[1]兖矿集团有限公司总医院普通外科,山东济宁272072

出　　处：《中华实用诊断与治疗杂志》2016年第11期1106-1107,共2页Journal of Chinese Practical Diagnosis and Therapy

基　　金：兖矿集团有限公司科技创新计划(20140917)

摘　　要：目的探讨乳腺癌根治术保留胸前神经及肋间臂神经的临床效果。方法乳腺癌患者106例,保留胸前神经及肋间臂神经53例为观察组,行乳腺癌根治术未保留胸前神经及肋间臂神经53例为对照组,比较2组手术时间,观察2组治疗后相关指标变化。结果观察组手术时间[(105.12±10.85)min]与对照组[(103.23±11.42)min]比较差异无统计学意义(P>0.05);观察组术后转移率(11.32%)、复发率(9.43%)及上肢水肿、上臂感觉障碍、上臂运动障碍、胸大肌萎缩发生率(7.55%、1.89%、1.89%、3.77%)均低于对照组(24.53%、26.41%、11.32%、7.55%、7.55%、13.21%)(P<0.05);2组治疗后躯体功能、角色功能、社会功能、情绪功能评分均较术前增高(P<0.05),且观察组治疗后躯体功能、角色功能、社会功能、情绪功能评分(59.98±7.13、65.22±6.74、62.82±5.43、56.39±6.39)明显高于对照组(52.13±6.42、59.75±5.17、51.63±4.38、45.75±6.15),差异均有统计学意义(P<0.05)。结论乳腺癌根治术保留胸前神经及肋间臂神经可降低术后转移率、复发率、并发症发生率,提高患者术后生活质量。Objective To investigate the clinical outcome of anterior thoracic and intercostobrachial nerve reservation in radical mastectomy for breast cancer. Methods A total of 106 patients with breast cancer were divided into observation group receiving anterior thoracic and intercostobrachial nerve reservation in radical mastectomy and control group receiving radical mastectomy without reserving anterior thoracic and intercostobrachial nerve, with 53 patients in each group. The related indexes were observed and compared between two groups. Results There was no significant difference in the operation lasting time between observation group （（105.12 ± 10.85） min） and control group （（103.23± 11.42） min） （P〉0.05）. The metastasis rate, relapse rate, and the incidences of upper limb edema, sensory disturbance of the upper arm, upper arm movement disorders and pectoralis major myocutaneous atrophy were significantly lower in observation group （11.32%, 9.43%, 7.55%, 1.89%, 1.89%, 3.77%） than those in control group （24.53%, 26.41%, 11. 32%, 7.55 %, 7.55 %, 13.21 %） （P〈0.05） after operation. The scores of physical function, role function, social function and emotional function were significantly higher in observation group （59.98±7.13, 65.22±6.74, 62.82±5.43, 56.39± 6.39） than those in control group （52. 13±6. 42, 59. 75±5. 17, 51. 63±4. 38, 45. 75±6. 15） （P〈0. 05） after operation. The scores of physical function, role function, social function and emotional function were significantly higher after operation than those before treatment in both groups （P（0.05）. Conclusion Anterior thoracic and intercostobrachial nerve reservation in radical mastectomy can reduce the metastasis rate, relapse rate and incidence of postoperative complications, and increase the quality of life of patients with breast cancer.

关 键 词：乳腺癌 乳腺癌根治术 胸前神经 肋间臂神经 

分 类 号：R737.9[医药卫生—肿瘤]