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目的探讨乳腺癌改良根治术中保留肋间臂神经的临床意义。方法 90例乳腺癌患者拟行乳腺癌改良根治术,术中清扫腋窝淋巴结时保留肋间臂神经74例,未能保留16例,术后分阶段对患者患侧上臂内侧皮肤感觉功能进行随访观察。结果保留和未能保留肋间臂神经的患者术后患侧上肢内侧均出现不同程度的疼痛及感觉异常,74例保留肋间臂神经的患者术后疼痛及感觉异常的程度较16例未能保留肋间臂神经的患者轻,症状持续及缓解恢复的时间短,疼痛症状缓解最为明显,切断肋间臂神经的患者症状多不能在短时间内缓解及完全恢复;术后随访6～36个月,90例均无肿瘤局部复发。结论在乳腺癌腋窝淋巴结清除术中,保留肋间臂神经是可行的,可以明显减少术后患侧上肢疼痛及感觉障碍,有利于提高患者生活质量。
Objective To investigate the clinical significance of preserving intercostobrachial nerve in radical mastectomy of breast cancer. Methods Totally 74 patients with breast cancer were treated by modified radical mastectomy. 74 cases of intercostobrachial nerves were reserved during axillary lymph node dissection in operation, and 16 cases were not retained. The sensory function of the medial upper arm of the affected patients was followed up . Results Patients with preserved and failed intercostobrachial nerves showed varying degrees of pain and sensory abnormalities in the medial upper limbs of the affected patients. The degree of postoperative pain and sensation in 74 patients with intercostobrachial nerve was not as good as that in 16 patients Patients with preserved intercostobrachial nerve were light, with sustained symptoms and short time of recovery and recovery, with the most obvious symptom of pain relief. The symptoms of patients with intercostobrachial nerve could not be relieved and recovered completely within a short period of time; 6 to 36 Month, 90 cases had no local tumor recurrence. Conclusions In the axillary lymph node dissection of breast cancer, it is feasible to retain the intercostobrachial nerve, which can significantly reduce the upper extremity pain and sensory disturbance after the operation, which is beneficial to improve the quality of life of patients.