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目的分析保留肋间臂神经在乳腺癌改良根治术中的临床效果。方法乳腺癌患者80例,随机分为观察组与对照组,每组各40例。观察组行保留肋间臂神经手术,对照组则将肋间臂神经同时清扫,比较两组患者手术时间、清扫淋巴结数量、术中出血量以及并发症发生率。随访两组患者术后上臂感觉障碍及复发转移情况。结果两组患者手术时间、手术清扫淋巴结数量及术中出血量比较,差异无统计学意义(P>0.05)。观察组并发症发生率为12.50%,对照组率为15.00%,两组比较,差异无统计学意义(P>0.05)。观察组术后1周上臂感觉障碍为10.00%,术后1个月为5.00%,术后3个月为2.50%,术后6个月为2.50%,术后12个月无。对照组分别为52.50%、47.50%、45.50%、37.50%和27.50%。观察组术后上臂感觉障碍发生率明显低于对照组(P<0.05)。随访1年,两组患者均无复发及转移。结论在乳腺癌改良根治术中保留肋间臂神经可以有效地降低术后患侧上臂感觉障碍发生率。
Objective To analyze the clinical effect of preserving intercostobrachial nerve in modified radical mastectomy of breast cancer. Methods 80 cases of breast cancer patients were randomly divided into observation group and control group, 40 cases in each group. The observation group retained the intercostobrachial nerve operation while the control group simultaneously cleaned the intercostobrachial nerve. The operation time, the number of lymph nodes dissected, the amount of intraoperative blood loss and the complication rate were compared between the two groups. Follow up the two groups of patients with upper arm sensory dysfunction and recurrence and metastasis. Results There was no significant difference in the operation time, the number of lymph nodes dissected between the two groups and the intraoperative blood loss (P> 0.05). The incidence of complications in the observation group was 12.50% and in the control group was 15.00%. There was no significant difference between the two groups (P> 0.05). The sensory disturbance of the upper arm in the observation group was 10.00% 1 week after surgery, 5.00% at 1 month after surgery, 2.50% at 3 months and 2.50% at 6 months after operation. The control group was 52.50%, 47.50%, 45.50%, 37.50% and 27.50% respectively. The incidence of upper arm sensory disturbance in the observation group was significantly lower than that in the control group (P <0.05). Follow-up 1 year, no recurrence and metastasis in both groups. Conclusions The preservation of intercostobrachial nerve in radical mastectomy of breast cancer can effectively reduce the incidence of upper limb sensory disturbance after operation.