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目的探讨对乳腺癌患者行改良根治术是否保留肋间臂神经对患者术后生活质量的影响。方法回顾性分析该院乳腺外科2009年3月~2013年5月收治的134例乳腺癌改良根治术患者的临床资料,根据术中是否保留患者的肋间臂神经分为观察组76例和对照组58例,比较两组患者平均手术时间、术后并发症发生情况、术后第1个月、第3个月、第6个月、第12个月的疼痛及感觉障碍情况、术后12个月生命质量评分情况。结果观察组患者的平均手术时间(113.4±24.2)min显著长于对照组的(96.7±21.8)min,差异有统计学意义(P<0.05)。观察组患者术后并发症发生率为7.89%低于对照组的12.07%,但差异无统计学意义(P>0.05)。观察组患者术后第1个月、第3个月、第6个月、第12个月的感觉及疼痛障碍发生率均显著低于对照组患者,差异有统计学意义(P<0.05)。观察组患者术后12个月的生存质量评分情况:生理状况(27.4±1.8)分、社会、家庭状况(23.6±2.1)分、情感状况(25.6±2.4)分、功能状况(23.8±1.7)分、附加关注条目(28.4±3.1)分、生活质量总分(128.8±7.4)分均显著高于对照组患者,差异有统计学意义(P<0.05)。结论乳腺癌患者行改良根治术保留肋间臂神经对降低患者术后感觉及疼痛障碍、提高生活质量有积极意义。
Objective To investigate the effect of modified radical mastectomy on the quality of life in patients with breast cancer after preserving the intercostobrachial nerve. Methods The clinical data of 134 patients with modified radical mastectomy admitted from March 2009 to May 2013 in our hospital from March 2009 to May 2013 were retrospectively analyzed. According to whether the intracranial intercostal nerve was preserved in the operation group, 76 cases were divided into observation group and control group (N = 58). The mean operative time, the incidence of postoperative complications, the pain and sensory disturbances in the first month, the third month, the sixth month and the twelfth month after operation were compared between the two groups. After operation, Month quality of life score. Results The average operative time (113.4 ± 24.2) min in the observation group was significantly longer than that in the control group (96.7 ± 21.8) min, with significant difference (P <0.05). The incidence of postoperative complications in the observation group was 7.89% lower than that in the control group (12.07%), but the difference was not statistically significant (P> 0.05). The incidence of sensory and pain disorders in the observation group at the first month, the third month, the sixth month and the twelfth month after operation were significantly lower than those in the control group (P <0.05). The quality of life scores of patients in observation group at 12 months after operation were: physiological status (27.4 ± 1.8), social and family status (23.6 ± 2.1), emotional status (25.6 ± 2.4), functional status (23.8 ± 1.7) (28.4 ± 3.1) points and the total score of quality of life (128.8 ± 7.4) points were significantly higher than those in the control group, the difference was statistically significant (P <0.05). Conclusion Modified radical mastectomy in breast cancer patients with intercostobrachial nerve to reduce postoperative sensory and pain disorders, improve the quality of life is of positive significance.