摘要
目的：探讨保留肋间臂神经和胸前神经在乳腺癌改良根治腋窝淋巴结清扫术中的应用。方法回顾性分析84例乳腺癌改良根治术患者的临床资料，其中腋窝淋巴结清扫时保留肋间臂神经和胸前神经的41例，另切除该组神经的43例；比较两组的手术时间、术中出血量、腋窝淋巴结清扫数目、上臂内侧、腋部及胸壁皮肤感觉异常及胸大肌萎缩情况。结果两组手术时间、术中出血量及清扫腋窝淋巴结数目分别为[（104．7±10．3）min vs （97．0±7．2）min]、[（100．8±15．2）ml vs （97．1±9．3）ml]、[（18．6±2．6）枚 vs （19．3±2．3）枚]，组间差异均无统计学意义（P＞0．05）；随访6个月感觉异常及胸大肌萎缩的发生率分别为14．6％ vs 62．8％、17．1％ vs 74．4％，两组相比保留神经组的发生率均显著低于未保留神经组（P＜0．01）。结论在乳腺癌改良根治腋窝淋巴结清扫术中保留肋间臂神经和胸前神经是安全可行的，可有效防止皮肤感觉障碍及胸大肌萎缩。
Objective To investigate the application of preserving the intercostobrachial nerve （ICBN）and anterior thoracic nerve（ATN）during axillary lymph node dissection in modified radical mas-tectomy for breast cancer.Methods The clinical data of 84 patients who underwent modified radical mas-tectomy for breast cancer were reviewed retrospectively.During the axillary lymph node dissection,ICBN and ATN were preserved in 41 cases and resected in the other 43 cases.The operative time,operation hem-orrhage,number of dissected lymph nodes,incidence rate of abnormal sensory function and atrophy of the major pectoral muscle were analyzed in all the patients.Results There were no significant differences in operative time [（104.7 ±10.3）min vs（97.0 ±7.2）min],hemorrhage [（100.8 ±15.2）ml vs（97.1 ± 9.3）ml]and lymph node number [（18.6 ±2.6）vs（19.3 ±2.3）]between the two groups（P〉0.05）. There were significant differences in the incidence rate of abnormal sensory function（14.6% vs 62.8%） and atrophy of the major pectoral muscle（17.1%vs 74.4%）between the preservation group and resection group（P〈0.01）.Conclusion Preservation of ICBN and ATN is a feasible and safe technique during ax-illary lymph node dissection in modified radical mastectomy for breast cancer.It could decrease the inci-dence of abnormal sensory function and atrophy of the major pectoral muscle.
出处
《临床外科杂志》
2014年第9期656-658,共3页
Journal of Clinical Surgery
基金
江苏省宿迁市指导性科技计划资助项目
关键词
肋间臂神经
胸前神经
乳腺癌
腋窝淋巴结清扫
intercostobrachial nerve
anterior thoracic nerve
breast cancer
axillary lymph node dissection
