保留肋間臂神經和胸前神經在乳腺癌改良根治術中的效果評價

周愛萍

【摘要】 目的：探討保留胸前神經和肋間臂神經的乳腺癌改良根治術治療乳腺癌的臨床效果及意義。方法：課題研究對象為2010年1月-2014年1月到筆者所在醫院進行治療的160例浸潤性乳腺癌患者，依據隨機數字表法將其分為對照組（87例）和觀察組（73例）。對照組采用經典的乳腺癌改良根治術，觀察組采用保留肋間臂神經和胸前神經的乳腺癌改良根治術，比較兩組患者術中及術后恢復情況。結果：觀察組手術時間明顯長于對照組[（78.55±10.32）min vs （63.76±9.80）min]，差異有統計學意義（t=4.734，P<0.05）。而淋巴結清掃數量和術中出血量組間比較，差異無統計學意義（P>0.05）。術后12個月隨訪結果示，對照組的并發癥發生率明顯高于觀察組（35.63% vs 6.85%），差異有統計學意義（字2=8.102，P<0.05）。結論：保留胸前神經和肋間臂神經的乳腺癌改良根治術對患側上肢運動及感覺功能影響較小，可顯著降低術后并發癥發生率，適宜推廣應用。

【關鍵詞】 乳腺癌改良根治術； 胸前神經； 肋間臂神經； 肌肉萎縮

doi：10.14033/j.cnki.cfmr.2017.29.006 文獻標識碼 B 文章編號 1674-6805（2017）29-0012-02

Evaluation of the Effect of Retaining Intercostal Nerve and Thoracic Nerve in Modified Radical Mastectomy for Breast Cancer/ZHOU Ai-ping.//Chinese and Foreign Medical Research，2017，15（29）：12-13

【Abstract】 Objective：To explore the clinical effect and significance of modified radical mastectomy for breast cancer with thoracic nerve and intercostal nerve.Method：160 patients with invasive breast cancer who underwent treatment from January 2010 to January 2014 were divided into control group（87 cases） and observation group（73 cases） according to the random number table method.The control group was treated with classical modified radical mastectomy.The observation group was treated with modified radical mastectomy with retained intercostal nerve and thoracic nerve.The operation and postoperative recovery were compared between the two groups.Result：The operation time of the observation group was significantly longer than that of the control group[（78.55±10.32）min vs （63.76±9.80）min]，the difference was statistically significant（t=4.734，P<0.05）.Compared with the number of lymph node dissection and intraoperative blood loss between the two groups，there were no significant differences（P>0.05）.The results of 12 months follow-up showed that the incidence of adverse events in the control group was significantly higher than that in the observation group[（35.63%） vs （6.85%）]，the difference was statistically significant（字2=8.102，P<0.05）.Conclusion：The modified radical mastectomy of retaining thoracic nerve and intercostal nerve has little effect on upper limb movement and sensory function，which can significantly reduce the incidence of postoperative complications and is suitable for popularization and application.

【Key words】 Breast cancer modified radical surgery； Thoracic nerve； Intercostal nerve； Muscle atrophy

First-authors address：Nanping First Hospital Affiliated to Fujian Medical University，Nanping 353000，Chinaendprint

據WHOT統計，乳腺癌目前已經是全世界女性發病率僅次于子宮頸癌的惡性腫瘤，而我國女性群體的發病率達到38.7/100 000，并且呈現年輕化趨勢，已經成為威脅婦女的身體與心理健康的重大負性事件[1]。目前，乳腺癌改良根治術已成為乳腺癌的首選治療方案。傳統乳腺癌改良根治術會損傷胸前神經及肋間臂神經，而造成胸肌失去神經支配而萎縮及術后發生腋窩疼痛綜合征等，給患者的心理和社會意識帶來了嚴重創傷[2]。本研究通過保留胸前神經與肋間臂神經，對傳統乳腺癌改良根治術進行改良，總結報道如下。

1 資料與方法

1.1 一般資料

課題研究對象為2010年1月-2014年1月到筆者所在醫院進行治療的160例浸潤性乳腺癌患者，依據隨機數字表法將其分為對照組（87例）和觀察組（73例）?！?br>