肋间臂神经在乳腺癌患者单染法前哨淋巴结活检术中的价值  

Value of Intercostal Brachial Nerve in Sentinel Lymph Node Biopsy by Single Dye Method of Breast Cancer Patients

作　　者：苗莹莹 卢文献 郭凯扬 朱会生 MIAO Ying-ying;LU Wen-xian;GUO Kai-yang;ZHU Hui-sheng(Department of Human Anatomy,Sanquan College of Xinxiang Medical University,Xinxiang 453003,China;the 83rd Army Hospital,Xinxiang 453003,China)

机构地区：[1]新乡医学院三全学院人体解剖学教研室,新乡453003 [2]陆军第八十三集团军医院,新乡453003

出　　处：《四川解剖学杂志》2024年第1期7-10,共4页Sichuan Journal of Anatomy

基　　金：2022年度河南省高等学校重点科研项目计划(22B310012);2021年河南省高等学校骨干教师培养计划项目(2021GGJS200);新乡医学院三全学院学术技术带头人计划(SQ3XSJSDTRO_(2))。

摘　　要：目的:探讨肋间臂神经(ICBN)在乳腺癌患者单染法前哨淋巴结活检术(SLNB)中的价值.方法:选取2018年1月至2022年7月新乡医学院三全学院收治的乳腺癌患者100例作为研究对象.按照SLNB中有无保留ICBN,将其分为保留组(n=50)和未保留组(n=50).对两组患者均于SLNB后随访12个月,比较两组患者上肢感觉、功能及疼痛评分.结果:术后1个月、6个月,两组感觉障碍程度及触觉程度构成比比较,差异均无统计学意义(P>0.05).术后12个月,保留组感觉迟钝构成比低于未保留组,感觉过度构成比高于未保留组,差异有统计学意义(P<0.05).术后1个月、6个月及12个月,保留组患者上肢Fugl-Meyer感觉功能评定(FMA)评分均高于未保留组,差异有统计学意义(P<0.05);视觉模拟评分法(VAS)、疼痛分级指数(PRI)以及疼痛强度(PPI),在术后1个月时两组之间差异无统计学意义(P>0.05);术后6个月及12个月,保留组VAS、PRI及PP评分明显低于未保留组,差异均有统计学意义(P<0.05).结论:SLNB术中保留ICBN可以改善患者上肢感觉和其他长期症状,同时ICBN与前哨淋巴结的解剖关系,也可能为SLNB提供一个新的解剖标志.Objective:To investigate the value of intercostal brachial nerve(ICBN)in sentinel lymph node biopsy(SLNB)by single dye of breast cancer patients.Methods:One hundred cases of breast cancer patients admitted to Sanquan college of Xinxiang medical university from January 2018 to July 2022 were selected and divided into reserved group(n=50)and unreserved group(n=50)according to whether the ICBN in SLNB was retained or not.Two groups of patients were followed up for 12 months after SLNB to compare the differences in upper limb sensation,function,and pain between the two groups.Results:At 1 and 6 months after surgery,there was no statistically significant difference in the proportion of sensory impairment and tactile sensation between the two groups(P>0.05).After 12 months of surgery,the proportion of sensory dullness in the reserved group was lower than that in the unreserved group,and the proportion of sensory hypersensitivity was higher than that in the unreserved group,with statistical significance(P<0.05).At 1 month,6 months,and 12 months after surgery,the Fugl-Meyer assessment scale(FMA)score of the upper limb in the preservation group was higher than that in the non preservation group,and the difference was statistically significant(P<0.05);The visual analogue scale(VAS),pain rating index(PRI),and present pain intensity(PPI)showed no statistically significant differences between the two groups at 1 month after surgery(P>0.05);At 6 and 12 months after surgery,the VAS,PRI,and PPI scores of the reserved group were significantly lower than those of the unreserved group,and the differences were statistically significant(P<0.05).Conclusions:Preservation of ICBN during SLNB surgery can improve upper limb sensation and other long-term symptoms in breast cancer patients,and the anatomical relationship between ICBN and sentinel lymph nodes may also provide a new anatomical marker for SLNB.

关 键 词：肋间臂神经 单染法前哨淋巴结 价值 

分 类 号：R737.9[医药卫生—肿瘤]