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目的探讨乳腺癌手术腋窝淋巴结清扫时保留肋间臂神经(ICBN)的临床意义。方法甘肃省定西市人民医院2002年1月至2006年1月对122例Ⅰ、Ⅱ、Ⅲa期乳腺癌病人行手术治疗。将其随机分为两组:治疗组(56例)行腋窝清扫术时保留ICBN,对照组(66例)行腋窝清扫术时常规切除ICBN,两组病人术后均按乳腺癌治疗,进行严密随访观察。结果治疗组及对照组术后1个月上臂内侧感觉障碍发生率分别为7.14%、56.06%(P<0.01),差异有统计学意义,经1～5年随访均无局部复发。结论对于Ⅰ、Ⅱ、Ⅲa期乳腺癌病人行腋窝淋巴结清扫术时,保留ICBN可明显减少病人术后患侧上臂内侧感觉障碍,提高生活质量。
Objective To investigate the clinical significance of preserving intercostobrachial nerve (ICBN) during axillary lymph node dissection in breast cancer surgery. Methods Dingxi People ’s Hospital of Gansu Province from January 2002 to January 2006 122 patients with stage Ⅰ, Ⅱ, Ⅲ a breast cancer patients underwent surgical treatment. They were randomly divided into two groups: the treatment group (56 cases) retained ICBN during axillary dissection, while the control group (66 cases) routine excision of ICBN during axillary dissection. Both groups were treated with breast cancer after surgery, Follow-up observation. Results The incidence of upper medial sensation in the treatment group and the control group at one month postoperatively was 7.14% and 56.06%, respectively (P <0.01). The difference was statistically significant. There was no local recurrence after 1 to 5 years of follow-up. Conclusions ICBN can significantly reduce the sensory dysfunction of the upper arm of the affected side and improve the quality of life in patients with stage Ⅰ, Ⅱ and Ⅲa breast cancer.