保留肋间臂神经在乳腺癌改良根治术中的可行性及临床意义

Clinical significance and feasibility of reserving intercostobrachial nerve during modified radical mastectomy

关键词:  肋间臂神经  乳腺癌  改良根治术

Key words:  Intercostobrachial nerve  Breast carcinoma  modified radical mastectomy

摘要:

［目的］ 探讨乳腺癌患者行乳腺癌改良根治术中保留肋间臂神经的可行性及临床意义。［方法］ 30例乳腺癌改良根治术保留肋间臂神经，32例切除肋间臂神经。保留肋间臂神经组用双极电凝显露保留肋间臂神经，术后随访比较两组患者术后上臂内侧及腋窝部皮肤感觉功能。肿瘤局部复发情况。［结果］ 保留肋间臂神经组30例，腋窝及上臂内侧皮肤感觉正常28例（占85%）。切除肋间臂神经组均有不同程度的皮肤感觉异常，严重者疼痛或烧灼感。两组间差异有统计学意义（P<0.001）。随访3~5年，两组均无肿瘤局部复发和远处转移。手术时间两组差异无显著性意义。 ［结论］ 保留肋间臂神经在Ⅰ、Ⅱ期乳腺癌改良根治术中是安全可行的，能有效保留患者上臂内侧及腋窝皮肤感觉功能，提高患者术后生活质量。

Abstract:

［Objective］ To investigate the feasibility and clinical significance of reserving intercostobrachial nerve (ICBN) during the modified radical mastectomy.［Methods］ Thirty cases of breast carcinoma received modified radical mastectomy with reserved intercostobrachial nerves and 32 cases did that with non-reserved intercostobrachial nerves. The intereostobrachial nerves were saved in lymphnode dissection. The sensation of medial upper arms and axilla was observed.［Results］ In the group of reserving ICBN, 28 patients (85%) had normal sensation on the skin of medial upper arms and axilla after operation. The patients of non-reserved intercostobrachial nerves had abnormal sensation on the skin of medial upper arms and axilla after operation, even feeling pain or cauterize. No recurrence was found during 3 to 5 years of follow-up in both groups. Operation time in both groups had no significant difference.［Conclusion］ Reserving ICBN in modified radical mastectomy for the patients with breast cancer, which is safe and has certain clinical significance, can obviously reduce the incidence of pain syndrome and improve the life quality of the patients after operations.