保留胸外侧动静脉及肋间臂神经的乳腺癌腋窝清扫术的临床效果  

Clinical effect of axillary dissection for breast cancer with preservation of lateral thoracic arteriovenous and intercostal brachial nerve

作　　者：李静[1] 任毅[1] LI Jing;REN Yi(Department of Breast,Xuzhou Cancer Hospital,Jiangsu Province,Xuzhou 221000,China)

机构地区：[1]江苏省徐州市肿瘤医院乳腺科,江苏徐州221000

出　　处：《妇儿健康导刊》2022年第8期124-127,共4页JOURNAL OF WOMEN AND CHILDREN'S HEALTH GUIDE

基　　金：江苏省徐州市科技局课题(KH17039)。

摘　　要：目的研究乳癌腋窝淋巴结清扫术中保留胸外侧动静脉血管及肋间臂神经的可能性及其临床效果。方法对2017年4月至2020年4月在徐州市肿瘤医院乳腺科就诊的294例乳腺癌患者采用抽签法随机分组,其中研究组143例,对照组151例。研究组行腋窝清扫术中尽可能地保留胸外侧动静脉及肋间臂神经,对照组常规进行结扎切除,观察并记录两组术后引流量、拔管时间、皮下积液发生率、乳房水肿发生率及患者的主观感受等情况。结果研究组中,有88例胸外侧动脉及85例胸外侧静脉得到保留,腋窝分期越晚神经血管保留的可能性越低。研究组的术后引流量、拔管时间、皮下积液发生率、乳房水肿发生率(放疗后1、3、6个月)低于对照组,患者主观感受优于对照组,差异有统计学意义(P<0.05)。两组手术时间、住院天数比较,差异无统计学意义(P>0.05)。经6~24个月随访均未发生局部复发。结论乳腺癌行腋窝淋巴结清扫术中保留胸外侧血管及肋间臂神经,安全可行,可降低术后医疗成本,提高患者生活质量。Objective To study the possibility and clinical effect of reserving lateral thoracic arteriovenous vessels and intercostal brachial nerves in axillary lymph node dissection for breast cancer.Methods A total of 294 breast cancer patients admitted to Department of Breast,Xuzhou Cancer Hospital from April 2017 to April 2020 were randomly divided into two groups by drawing lots,including 143 patients in the study group and 151 patients in the control group.In the study group,the lateral thoracic artery and vein as well as the intercostal brachial nerve in the breast cancer patients undergoing axillary dissection were retained as much as possible during the operation,while the control group was given routine ligation.The postoperative drainage,extubation time,incidence of subcutaneous effusion,incidence of breast edema and subjective feelings of the two groups were observed and recorded.Results In the study group,88 cases of lateral thoracic artery and 85 cases of lateral thoracic vein were preserved.The later the axillary stage was,the lower the possibility of neurovascular preservation was.The postoperative drainage volume,extubation time,incidence of subcutaneous effusion and incidence of breast edema(1,3,and 6 months after radiotherapy)in the study group were lower than those in the control group,the patients’subjective feeling was better than that in the control group,and the differences were statistically significant(P<0.05).There were no significant differences in operation time and hospitalization days between the two groups(P>0.05).No local recurrence occurred during follow-up of 6 to 24 months.Conclusion During axillary lymph node dissection for breast cancer,the preservation of lateral thoracic ves sels and intercostal brachial nerve is safe and feasible,reduces po stoperative costs and improves patients’quality of life.

关 键 词：乳腺癌 淋巴结清扫术 胸外侧动静脉 肋间臂神经 

分 类 号：R737[医药卫生—肿瘤]