论文部分内容阅读
目的研究保留肋间臂神经的乳腺癌改良根治术与传统乳腺癌改良根治术临床疗效的比较。方法回顾性研究2010年1月~2012年1月接受乳腺癌改良根治术腋窝淋巴结清扫时保留肋间臂神经的59例Ⅰ、Ⅱ、Ⅲa期乳腺癌患者的临床资料(病例组),以及2008年1月~2010年1月接受乳腺癌改良根治术腋窝淋巴结清扫时未保留肋间臂神经的53例Ⅰ、Ⅱ、Ⅲa期乳腺癌患者的临床资料(对照组)。比较两组术中淋巴结清扫数目、手术时间及术后上臂内侧感觉变化情况等。结果两组在淋巴结清扫数目和手术时间的比较差异无显著性(P>0.05),术后两组均随访1年,两组均无局部复发、转移或死亡。病例组术后1年患侧上臂内侧感觉异常发生率为6.8%显著低于对照组73.6%,组间差异有显著性(P<0.01)。结论Ⅰ、Ⅱ、Ⅲa期乳腺癌行根治术时保留肋间臂神经,可在不影响手术质量和术后局部复发率的前提下,显著减轻患者术后上臂内侧感觉障碍,改善生活质量。
Objective To study the clinical efficacy of modified radical mastectomy for conserving intercostobrachial nerve and modified radical mastectomy for traditional breast cancer. Methods The clinical data (case group) of 59 patients with stage Ⅰ, Ⅱ, Ⅲa breast cancer who underwent modified radical mastectomy for axillary lymph node dissection from January 2010 to January 2012 were retrospectively studied. The clinical data of 53 patients with stage Ⅰ, Ⅱ, Ⅲa breast cancer who did not retain the intercostobrachial nerve during axillary lymph node dissection with modified radical mastectomy from January to January 2010 were included in this study. The number of lymph node dissection, the operation time and the change of sensation of the upper arm after operation were compared between the two groups. Results There was no significant difference between the two groups in the number of lymph node dissection and operation time (P> 0.05). Both groups were followed up for 1 year. There was no local recurrence, metastasis or death in both groups. In the case group, the incidence of sensory abnormality in the medial upper arm at 1 year after operation was 6.8%, which was significantly lower than that in the control group (73.6%). There was significant difference between the two groups (P <0.01). Conclusion The survival of intercostobrachial nerve in radical mastectomy for stage Ⅰ, Ⅱ and Ⅲa breast cancer can significantly reduce the postoperative upper arm sensory disturbance and improve the quality of life without affecting the quality of operation and postoperative local recurrence.