术中保留胸前与肋间臂神经在早期乳腺癌手术中的应用效果  

Application of Intraoperative Preservation of Anterior and Intercostal Brachial Nerves in Patients with Early Breast Cancer

作　　者：刘社景 李林[1] 赫阳森 LIU Shejing;LI Lin;HE Yangsen(The First Affiliated Hospital of Zhengzhou University,Zhengzhou,450000)

机构地区：[1]郑州大学第一附属医院,450000

出　　处：《实用癌症杂志》2023年第4期672-675,共4页The Practical Journal of Cancer

摘　　要：目的 研究术中保留胸前与肋间臂神经在早期乳腺癌手术中的应用效果。方法 回顾性分析87例女性早期乳腺癌患者的临床资料,按手术方案不同分成对照组42例、研究组45例。对照组接受乳腺癌标准根治术治疗(术中未对胸前与肋间臂神经保留),研究组接受改良式乳腺癌根治术治疗(术中对胸前及肋间臂神经保留)。对比两组围术期指标、临床疗效、乳房美观度、术后并发症发生率、复发率和远处转移率。结果 研究组手术时间较对照组延长,术后引流量、术后引流时间和住院时间较对照组减少,差异有统计学意义(P<0.05);两组术中出血量对比,差异无统计学意义(P>0.05);两组治疗总缓解率对比,差异无统计学意义(P>0.05);研究组患者术后3个月乳房美观度优于对照组,差异有统计学意义(P<0.05);研究组术后并发症发生率、复发率和远处转移发生率较对照组均略低,差异无统计学意义(P>0.05)。结论 术中保留胸前与肋间臂神经在早期乳腺癌手术患者中的应用效果确切,利于患者尽早恢复,并可避免手术治疗对患者乳房外观美观度造成的影响,维持乳房形态,减少术后并发症、复发和远处转移的发生,值得临床推广。Objective To study the effect of preserving thoracic and intercostal brachial nerves in patients with early breast cancer.Methods Clinical data of 87 female patients with early breast cancer were retrospectively analyzed.They were divided into 42 cases in the control group and 45 cases in the study group according to the operative plan.The control group received standard radical mastectomy(preservation of the anterior and intercostal brachial nerves)while the study group received modified radical mastectomy(preservation of the anterior and intercostal brachial nerves).The perioperative indexes,clinical efficacy,breast beauty,incidence of postoperative complications,recurrence rate and distant metastasis rate were compared between the two groups.Results the operation time in the study group was longer than that in the control group,and the postoperative drainage volume,postoperative drainage time and hospital stay were less than those in the control group(P<0.05);There was no significant difference in intraoperative bleeding between the 2 groups(P>0.05);There was no significant difference in the total remission rate between the two groups(P>0.05);The beauty of breast in the study group was better than that in the control group 3 months after operation,and the difference was statistically significant(P<0.05);The incidence of postoperative complications,recurrence and distant metastasis in the study group were slightly lower than those in the control group(P>0.05).Conclusion The preservation of the anterior and intercostal brachial nerves in patients with early breast cancer is effective,and is beneficial to early recovery of patients,and can avoid the influence of surgical treatment on breast appearance,maintain breast morphology,reduce postoperative complications,recurrence and distant metastasis,and is worthy of clinical promotion.

关 键 词：胸前神经 肋间臂神经 改良式乳腺癌根治术 乳腺癌标准根治术 早期乳腺癌 

分 类 号：R737.9[医药卫生—肿瘤]