保留肋间臂神经与不保留肋间臂神经对乳腺癌改良根治术患者的影响  

Effect of preserved and unpreserved intercostal brachial nerve on patients undergoing modified radical mastectomy for breast cancer

作　　者：张利军[1] 张露文 任美田 ZHANG Lijun;ZHANG Luwen;REN Meitian(Department of Thyroid and Breast Surgery,Jiaozuo Second People’sHospital,Jiaozuo 454001,He’nan,China)

机构地区：[1]焦作市第二人民医院甲状腺乳腺外科,河南焦作4540010

出　　处：《癌症进展》2024年第15期1689-1692,共4页Oncology Progress

摘　　要：目的探讨保留肋间臂神经与不保留肋间臂神经对乳腺癌改良根治术患者的影响。方法根据手术方式的不同将152例乳腺癌改良根治术患者分为切除组(n=71)和保留组(n=81),切除组患者术中不保留肋间臂神经,保留组患者术中保留肋间臂神经。比较两组患者的围手术期指标、上肢感觉障碍发生情况、患侧上肢活动情况以及并发症发生情况。结果两组患者手术时间、术中出血量、淋巴结清扫数目、术后引流管拔除时间、术后住院时间及并发症总发生率比较,差异均无统计学意义(P﹥0.05)。术后1周,两组患者患侧上肢外展、后伸、前屈活动度均小于本组术前,保留组患者患侧上肢外展、后伸、前屈活动度均大于切除组,差异均有统计学意义(P﹤0.05)。保留组患者上肢感觉障碍总发生率为9.88%,低于切除组患者的25.35%,差异有统计学意义(P﹤0.05)。结论保留肋间臂神经与不保留肋间臂神经对乳腺癌改良根治术患者围手术期指标及并发症发生率的影响不大,但保留肋间臂神经对患者术后上肢感觉功能影响更小,患者患侧上肢活动度更大。Objective To investigate the effect of preserved and unpreserved intercostal brachial nerve on patients un-dergoing modified radical mastectomy for breast cancer.Method A total of 152 breast cancer patients underwent modi-fied radical mastectomy were divided into resection group(n=71)and reservation group(n=81)according to different sur-gical methods.The intercostal brachial nerve was not preserved in the resection group during operation,and the intercos-tal brachial nerve was preserved in the preservation group during operation.The perioperative indexes,the incidence of upper limb sensory disorders,the activity of the affected upper limb,and the incidence of complications were compared between the two groups.Result There were no significant differences in operation time,intraoperative blood loss,num-ber of lymph node dissection,postoperative drainage tube removal time,postoperative hospital stay and total incidence of complications between the two groups(P>0.05).At 1 week after operation,The range of motion for abduction,extension and flexion on the affected upper limb side in two groups were lower than those before operation,the range of motion for abduction,extension and flexion on the affected upper limb side in preservation group were higher than those in resection group,and the differences were statistically significant(P<0.05).The total incidence of upper limb sensory disorders in reservation group was 9.88%,which was lower than 25.35%in resection group,and the difference was statistically signifi-cant(P<0.05).Conclusion Preserved and unpreserved intercostal brachial nerve have little effect on perioperative index-es and incidence of complication of breast cancer patients undergoing modified radical mastectomy,but preserved inter-costal brachial nerve has less effect on postoperative upper limb sensory function and greater range of motion on the af-fected upper limb side.

关 键 词：乳腺癌改良根治术 保留肋间臂神经 不保留肋间臂神经 

分 类 号：R737.9[医药卫生—肿瘤]