术中保留肋间臂神经改良根治术(Auchincloss术)治疗乳腺癌患者的短期随访研究  

Short-term Follow-up Study of Patients with Breast Cancer Treated by Modified Radical Intercostal Nerve Resection(Auchincloss)during Surgery

作　　者：陈超阳 陈树群[1] 张业[1] 郭文伟[1] 郑雪文 陈裕群 CHEN Chao-yang;CHEN Shu-qun;ZHANG Ye;GUO Wen-wei;ZHENG Xue-wen;CHEN Yu-qun(Department of Oncology,Puning Overseas Chinese Hospital,Puning,Guangdong Province,515300 China)

机构地区：[1]广东省普宁华侨医院肿瘤外科,广东普宁515300

出　　处：《中外医疗》2020年第11期55-57,共3页China & Foreign Medical Treatment

摘　　要：目的研究术中保留肋间臂神经(Intercostobrachial nerve,ICBN)改良根治术(Auchincloss术)治疗乳腺癌患者的短期疗效。方法方便选取2015年4月—2018年12月该院患者120例,依据随机数字表法分为对照组、观察组,各60例。两组均行Auchincloss术,对照组术中切除ICBN,观察组术中保留ICBN。比较两组术后1、3、6个月上臂内侧感觉异常发生率及术后并发症发生率、预后情况(局部复发率、远处转移率)、手术前后乳腺癌患者生存质量量表(FACT-B)评分。结果术后1、3、6个月,观察组上臂内侧感觉异常发生率13.33%、11.67%、5.00%均低于对照组43.33%、38.33%、33.33%(χ21=13.297,χ22=11.378,χ23=15.545,P<0.001);两组局部复发率、远处转移率比较差异无统计学意义(P>0.05);与对照组比较,术后观察组FACT-B评分较高(t=10.905,P<0.001)。结论术中保留ICBN Auchincloss术治疗乳腺癌患者,可降低上臂内侧感觉异常发生率,安全性高,且预后情况良好,提高生存质量。Objective To study the short-term efficacy of Intercostobrachial nerve(ICBN)modified radical mastectomy(Auchincloss)during the treatment of breast cancer patients.Methods A total of 120 patients in the hospital from April 2015 to December 2018 were conveniently selected and divided into a control group and an observation group,with 60 cases in each group.Both groups underwent Auchincloss,the control group had ICBN removed during the operation,and the observation group retained ICBN during the operation.The incidence of paresthesia in the upper arm,the incidence of postoperative complications,the prognosis(local recurrence rate,distant metastasis rate),and the quality of life of breast cancer Scale(FACT-B)score patients before and after surgery were compared between the two groups at 1 month,3 months,and 6 months.Results The incidence of paresthesia in the upper arm of the observation group was 13.33%,11.67%,and 5.00%at 1 month,3 months,and 6 months after operation,which were lower than the control group at 43.33%,38.33%,and 33.33%(χ21=13.297,χ22=11.378,χ23=15.545,P<0.001);there was no significant difference in the incidence of postoperative complications,local recurrence,and distant metastasis between the two groups(P>0.05).Compared with the control group,the postoperative observation group had a higher FACT-B score(t=10.905,P<0.001).Conclusion The ICBN Auchincloss operation during the treatment of breast cancer patients can reduce the incidence of paresthesia in the upper arm,is safe,has a good prognosis,and improves the quality of life.

关 键 词：肋间臂神经 Auchincloss改良根治术 乳腺癌 

分 类 号：R737[医药卫生—肿瘤]