乳腺癌腋窝淋巴结清扫术中保留肋间臂神经的临床意义

乳腺癌腋窝淋巴结清扫术中保留肋间臂神经的临床意义

[摘要] 目的研究乳腺癌腋窝淋巴结清扫术中保留肋

间臂神经的临床意义，为临床提供依据。方法方便选取2013年1月―2015年6月在该院诊治的70例乳腺癌患者资料进行分析，入选患者均行乳腺癌腋窝淋巴结清扫术治疗，根据患者术中是否保留间臂神经分为对照组和实验组，每组35例。对照组乳腺癌腋窝淋巴结清扫术中切除肋间臂神经，实验组乳腺癌腋窝淋巴结清扫术中保留肋间臂神经，比较两组临床疗效。结果两组患者术后腋窝、上臂后侧、上臂前侧感觉障碍差异无统计学意义（P>0.05）；实验组治疗后上臂内侧14.3%、上臂外侧0.0%，显著低于对照组（上臂内侧25.7%、上臂外侧8.6%）（P0.05）；试验组手术时间（82.4±13.2）min 较长，显著多于对照组（68.7±11.3）min（P<0.05）。结论乳腺癌腋窝淋巴结清扫术中保留肋间臂神经能改善患者客观

感觉，提高患者生存质量，值得推广应用。

[关键词] 乳腺癌腋窝淋巴结清扫术；肋间臂神经；临床意义

[中图分类号] R4 [文献标识码] A [文章编号] 1674-0742（2016）04（a）-0041-03

[Abstract] Objective To research the clinical significance of

preserving intercostobrachial nerve in axillary lymphadenectomy in breast cancer and provide basis for clinical treatment. Methods 70 cases of patients with breast cancer diagnosed and treated in our hospital from January 2013 to June 2015 were selected and divided into two groups with 35 cases in each according to whether the intercostobrachial nerve was preserved or not in operation，the intercostobrachial nerves of the control group were removed in axillary lymphadenectomy in breast cancer，the intercostobrachial nerves of the experimental group were preserved in axillary lymphadenectomy in breast cancer，and the clinical curative effects were compared between the two groups. Results The differences in the sensory disorders distributed in postoperative axillary，posterior upper arm and anterior upper arm between the two groups had no statistical significance，（P>0.05），the proportions with sensory disorders distributed in medial upper arm and lateral upper arm after treatment in the experimental group were obviously lower than those in the control group，（14.3%，0.0% vs 25.7%，8.6%），（P0.05），the operation time in the test group was obviously longer than that in the control group，[（82.4±13.2）min vs （68.7±11.3）min]（P<0.05）. Conclusion Preserving intercostobrachial nerve in

axillary lymphadenectomy in breast cancer can improve the objective sense and improve the survival quality of patients，which is worth promotion and application.

[Key words] Axillary lymphadenectomy in breast cancer；Intercostobrachial nerve；Clinical significance

乳腺癌是临床上常见的女性恶性肿瘤，且临床上主要以乳腺癌根治术治疗为主，缩小手术范围，减少术中各种损伤成为新的发展趋势[1]。但是腋窝淋巴结清扫仍然是乳腺癌手术的重要部分，常规清扫术治疗时仅保留胸长神经和胸背神经，忽略了支配感觉的肋间臂神经，导致患者乳腺癌腋窝淋巴结清扫术后患侧皮肤感觉障碍，降低了患者生活质量。近年来，乳腺癌腋窝淋巴结清扫术中保留肋间臂神经研究较多，但是其临床效果尚存在较大的争议[2]。为了探讨乳腺癌腋窝淋巴结清扫术中保留肋间臂神经的临床意义。方便选取2013年1月―2015年6月在该院诊治的70例乳腺癌患者资料进

行分析，现报道如下。 1 资料与方法

1.1 一般资料

方便选取在该院诊治的70例乳腺癌患者资料进行分析，根据患者术中是否保留间臂神经分为对照组和实验组。实验组35例，年龄32～66岁，平均（49.6±2.5）岁。对照组35例，年龄30～67岁，平均（50.2±2.6）岁。入选患者均行Auchincloss 改良根治术治疗，且患者均符合第6版美国癌症