摘要
目的对乳腺癌腋窝淋巴结清扫术中保留肋间臂神经(ICBN)的临床价值与可行性进行多因素分析。方法随机选择27例Ⅰ、Ⅱ期乳腺癌患者施行完整保留ICBN的乳腺癌腋窝淋巴结清扫术,同时选择22例切除ICBN的患者作为对照。对手术时间、术中清扫和术后复查的淋巴结数目、术后主观感觉与客观神经检查多方面进行比较。结果保留肋间臂神经组与切除组比较,手术时间、术中淋巴结清扫数目、术后2周和6个月B超复查腋淋巴结均无显著性差异,而术后5d(P<0.05)、30d(P<0.05)、3个月(P<0.05)的上臂内侧及腋部皮肤麻木与疼痛感发生率、神经检查阳性率均具有显著性差异。结论在Ⅰ、Ⅱ期乳腺癌的腋淋巴结清扫术中保留肋间臂神经是可行的,不影响清扫效果,不增加局部复发率,可减少患者术后的局部麻木与痛感的发生,具有良好的临床应用价值。
Objective To investigate the clinical value and feasibility of preservation of intercostobrachial nerve （ICBN） in axillary lmphadenectomy by multi - factor analysis. Methods From January 2007 to January 2008,27 cases of Ⅰ - Ⅱ stage breast cancer were selected randomly to undergo surgery with reserved ICBN. 22 cases with nerve resected were selected by contrast. The operation time and the number of dissected nodes of axillary lmphadenectomy were observed, and local recurred nodes of axillary were observed during recheck. All of the patients were followed up with sensation of the arm and neurologic examination. Results Among the 27 patients with ICBN reservation,sensory disturbance and abnormality in neurologic examination of affected upper medial arm and axilla was much less than the group with ICBN resected at 5 days ,30 days,3 months after operation. The time of axillary lmphadenectomy and the number of dissected nodes were of no significant difference. Local recurred nodes at 2 weeks, half - year were of no significant difference between two groups. Conclusions Preservation of ICBN in axillary lymphadenectomy of Ⅰ - Ⅱ stage breast cancer is feasible and leads to a significant decrease in the sensory disturbance of the upper medial arm and axilla,without interfering with the time of opera- tion, the number of dissected nodes, and local relapse rate.
出处
《北京医学》
CAS
2009年第1期31-33,共3页
Beijing Medical Journal
