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目的为乳腺癌腋窝淋巴结清扫术中预防侧胸壁、腋窝及上臂后内侧感觉异常提供解剖学基础认识。方法解剖30具成人尸体的60侧腋区,观察肋间臂神经(ICBN)及其毗邻关系,详细测量并记录其起源、走行、分支、分布及交通支。结果本组60侧中侧胸壁以第三肋间神经(50侧)和ICBN(29侧)分布为主,未观察到臂内侧皮神经(MBCN)分布至此;腋窝区第三肋间神经、ICBN和MBCN均有分布,但以ICBN分布为主(42侧);上臂后内侧ICBN(42侧)和MBCN(44侧)的分布基本持平,未观察到第三肋间神经分布至此。81.7%(49侧)的ICBN与臂丛存在交通支。63.3%(38侧)的ICBN穿出胸壁时存在伴行血管。结论乳腺癌腋窝淋巴结清除术中找到ICBN及相关神经及其间的交通支,并完整保留,可能更有利于预防患者腋窝淋巴结清扫术后感觉异常的发生。
Objective To provide an anatomical basis for the prevention of lateral sensory anomalies in the lateral chest wall, armpits and upper arm in axillary lymph node dissection of breast cancer. Methods 30 axillary regions of 60 adult cadavers were dissected and the intercostobrachial nerves (ICBNs) and their adjacent relations were observed. The origin, travel, branch, distribution and traffic branch were measured and recorded in detail. Results The medial chest wall of 60 sides was dominated by the third intercostal nerve (50 sides) and ICBN (29 sides), and no distribution of medial arm medial cutaneous nerve (MBCN) was observed. The third intercostal nerve, ICBN And MBCN, but mainly in ICBN (42 sides). The distribution of the medial ICBN (42 sides) and MBCN (44 sides) in the upper arm was basically the same, and no distribution of the third intercostal nerve was observed. 81.7% (49 sides) of ICBN and brachial plexus traffic branch. 63.3% (38 sides) of the ICBN piercing the chest wall with accompanying blood vessels. Conclusion ICBN and related nerves and the traffic branch between them can be found in axillary lymph node dissection of breast cancer, and they are completely preserved. It may be more beneficial to prevent the sensory abnormality after axillary lymph node dissection in patients with breast cancer.