摘要
目的探讨乳腺癌腋淋巴结清扫术和腋部副乳切除手术肋间臂神经损伤症状的差异及原因。方法 60例Ⅰ、Ⅱ、Ⅲa期乳腺癌患者按随机数字表分为2组,研究组27例行保留肋间臂神经腋淋巴结清扫术,对照组33例不保留肋间臂神经,术后2组均按乳腺癌指南治疗。另腋部副乳患者30例(腋部副乳组)行常规切除。3组均随访6个月。结果研究组和对照组术后发生上肢感觉异常分别为18.5%和60.6%(χ2=10.823,P<0.01),疼痛发生率分别为7.4%和36.4%(χ2=6.960,P<0.01),未发现局部复发。腋部副乳组发生上肢感觉异常和疼痛分别为86.7%和10.0%。结论在腋淋巴结清扫术中,保留肋间臂神经主干明显减少术后出现感觉异常、疼痛,且可恢复。腋部副乳切除术损伤的是肋间臂神经末梢分支,感觉异常、疼痛可恢复,误伤肋间臂神经主干则与腋淋巴结清扫术切除肋间臂神经的症状和转归相同。
Objectives To investigate the symptoms of intercostobrachial nerve（ICBN） injury after axillary lymph node excision and accessory breast operations,and to study the reasons for the symptoms.Methods Sixty cases of stage Ⅰ,Ⅱ,Ⅲa breast cancer were divided into experimental group（27 cases） and control group（33 cases）.ICBN was reserved in experimental group,but excised in control group.Patients in both groups were treated according to the practice guideline for breast cancer treatment.In addition,the accessory breast tissue were resected in 30 patients with accessory breast（accessory breast group）.All patients were followed up for 6 months.Results The incidence of postoperative arm sensory disturbance in experimental group and control group was respectively 18.5% and 60.6%（χ2=10.823,P〈0.01）,the incidence of pain was respectively 7.4% and 36.4%（χ2=6.960,P〈0.01）,and no recurrence was observed during the 6-month follow-up.In addition,the incidence of arm sensory disturbance and pain was respectively 86.7% and 10.0% in accessory breast group.Conclusion Preserving ICBN during axillary lymph node excision can significantly decrease the postoperative morbidity of arm sensory disturbance and pain in stage Ⅰ,Ⅱ,Ⅲa breast cancer patients,but ICBN may be injured during accessory breast resection.The symptoms and prognosis of accidental ICBN trunk injury are the same as those of ICBN injury induced by axillary lymph node dissection.
出处
《实用临床医学（江西）》
CAS
2010年第9期58-59,61,共3页
Practical Clinical Medicine
关键词
乳腺肿瘤
淋巴结切除术
肋间臂神经
副乳
breast neoplasm
lymph node excision
intercostobrachial nerve
accessory breast
