保留ATN、ICBN手术治疗Ⅰ~Ⅱ期乳腺癌的可行性及安全性分析  

Feasibility and safety analysis of ATN and ICBN-preserved surgery for stageⅠ-Ⅱbreast cancer

作　　者：程文 曾安贵 李攀 王毅 卢增红[2] Cheng Wen;Zeng Angui;Li Pan;Wang Yi;Lu ZengHong(Department of nail and breast surgery,Affiliated Hospital of Panzhihua University,617067;The First Affiliated Hospital of Gannan Medical College,341000)

机构地区：[1]攀枝花学院附属医院甲乳外科,617067 [2]赣南医学院第一附属医院,341000

出　　处：《中华普外科手术学杂志（电子版）》2021年第3期310-313,共4页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

基　　金：江西省卫生厅科技计划(20143126)。

摘　　要：目的分析保留胸前神经(ATN)、肋间臂神经(ICBN)手术治疗Ⅰ~Ⅱ期乳腺癌的可行性及安全性。方法回顾性分析2016年2月至2019年2月实施乳腺癌根治术的113例Ⅰ~Ⅱ期乳腺癌患者临床资料,将术中保留ATN、ICBN的60例患者纳入保留组,53例患者纳入未保留组。采用SPSS22.0软件进行处理,手术相关指标、生命质量测量表(FACT-B)评分以(x±s)表示,独立t检验,并发症、复发/转移用百分比表示,用χ^(2)检验,P<0.05差异有统计学意义。结果保留组手术时间长于未保留组(P<0.05);保留组术中出血量及淋巴结清除数目相比未保留组,差异无统计学意义(P>0.05);保留组术后6个月乳腺癌患者FACT-B量表各维度评分高于保留组(P<0.05);保留组术后并发症发生率(10.0%)、复发/转移率(11.7%)相比未保留组(26.4%、30.2%)低(P<0.05)。结论乳腺癌根治术术中保留ATN、ICBN虽延长手术时间,但可改善Ⅰ~Ⅱ期乳腺癌患者生活质量,减少术后并发症,降低复发/转移风险,可行性及安全性均较高。Objective To analyze the feasibility and safety of the thoracic nerve(ATN)and intercostobrachial nerve(ICBN)-preserved surgery for patients with stageⅠ-Ⅱbreast cancers.Methods From February 2016 to February 2019,a retrospective analysis was performed in 113 patients with stageⅠ-Ⅱbreast cancer who underwent radical mastectomy in our hospital,including 60 patients who preserved ATN and ICBN in preserved group and rest of 53 patients in non-preserved group.Statistical analysis were performed by using SPSS 22.0 software.Measurement data,such as the related indexes of operation and the score of life quality measurement table(FACT-B)were expressed as (x±s),and were examined by using independent test.Count data such as complications,recurrence/metastasis were expressed as percentages,and examined by using chi square test.A P value of<0.05 was considered as statistically significant difference.Results The operation time in the preserved group was longer than that in the non-preserved group(P<0.05).The blood loss and harvested lymph nodes in the preserved group were similar to thoses in non-preserved group,with significant difference(P>0.05).The score of each dimension of FACT-B scale of breast cancer patients in the preserved group was higher than that in the non-preserved group 6 months after operation(P<0.05).Compared with the non-preserved group(P<0.05),the incidence of postoperative complications of(26.4%vs.10.0%)and recurrence/metastasis rate of(30.2%vs.11.7%)were much better in the preserved group,with significant difference(P<0.05).Conclusion Although preservation of ATN and ICBN during radical breast cancer surgery prolongs the operation time,it could improve the quality of life of patients with stageⅠ-Ⅱbreast cancer,could reduce postoperative complications and could also reduce the risk of recurrence/metastasis with high feasibility and safety.

关 键 词：乳腺肿瘤 乳房切除术 根治性 胸前神经 肋间臂神经 手术后并发症 

分 类 号：R73[医药卫生—肿瘤]