检索历史 清除

目的 评价乳腺癌腋窝淋巴结清扫术中保留肋间臂神经对术后患侧上肢感觉功能及运动功能恢复的影响及保留方法.方法 96例乳腺癌患者采用Auchincloss术式治疗.根据是否保留肋间臂神经分为完全保留组51例,部分保留组27例,完全切除组18例.对比分析各组术后患侧上臂感觉功能及运动功能恢复情况.结果 术后1周,完全保留组及部分保留组患侧上肢的局部麻木感觉的发生率分别为11.8%(6/51)、40.7%(11/27),均明显低于完全切除组的72.2%(13/18)(P<0.05或<0.01);各组的局部疼痛感觉和患侧上肢运动情况比较差异无统计学意义.术后1年,完全保留组及部分保留组患侧上肢局部疼痛感觉发生率分别为23.5%(12/51)、14.8%(4/27),显著低于完全切除组的50.0%(9/18)(P<0.05),完全切除组患侧上肢皮肤感觉障碍的总体面积大于完全保留组(JP<0.01)及部分保留组(P<0.05).各组腋窝复发率及远处转移率比较差异无统计学意义.结论 乳腺癌腋窝淋巴结清扫术中应尽量保留肋间臂神经.

Objective To investigate the significance of preserving the intercostobrachial nerve (ICBN) during axillary node clearance for breast cancer and share, some technical experiences of this procedure. Methods ICBN was preserved integally or partially in 78 patients of breast cancer (ICBN preserved group) and resected integrally (ICBN resected group) in 18 patients. Sensory disorders and motorial recoveries as well as tumor recurrence were compared between the two groups one week and one year after operation. Results Morbidity of sensory disorders in ICBN preserved group was less than that in ICBN resected group. Motorial recoveries were better in ICBN preserved patients without decreasing the number of axillary nodes resected and without increasing the recurrence of tumor. Conclusion ICBN should be preserved as far as possible during axillary node clearance for breast cancer.