摘要
目的探讨乳腺癌改良根治术(MRM-BC)保留肋间臂神经(ICBN)对乳腺癌患者临床疗效、肩关节功能及术后疼痛的影响。方法采用随机数字表法将166例行MRM-BC的乳腺癌患者分为观察组和对照组各83例。对照组切除ICBN,观察组保留ICBN,比较两组患者临床疗效、肩关节功能、术后疼痛及远期预后的差异。结果观察组患者术后1个月皮肤感觉障碍、肩关节运动障碍发生率分别为14.46%(12/83)、3.61%(3/83),均低于对照组的33.73%(28/83)、14.46%(12/83),差异均有统计学意义(P﹤0.05)。观察组患者术后1周、1个月、3个月、12个月疼痛发生率均低于对照组,差异均有统计学意义(P﹤0.05)。两组患者手术时间、住院天数、术中出血量、清除病灶数以及1年生存率、3年生存率、局部复发发生率、远处转移发生率比较,差异均无统计学意义(P﹥0.05)。结论对乳腺癌患者实施MRM-BC治疗保留ICBN可在不影响手术质量的前提下,减轻患者术后皮肤感觉及肩关节运动障碍,以获得理想的近期效果,且具有长期术后减痛的优点,术中保留ICBN不影响患者术后1年、3年生存率,局部复发、远处转移率低,远期生存质量良好。
Objective To investigate the effect of modified radical mastectomy for breast cancer(MRM-BC)with intercostobrachial nerve(ICBN)preservation on the clinical efficacy,shoulder function and postoperative pain of patients with breast cancer.Method A total of 166 breast cancer patients who underwent MRM-BC were enrolled in the study and were divided as study group and control group following a random number table,with 83 cases in each group.The control group had ICBN resection,while the study group had ICBN preservation during radical mastectomy.The clinical efficacy,shoulder function,postoperative pain and long-term prognosis were compared between the two groups.Result The incidence of disturbance of skin sensation and scapular dyskinesia in 1 month after surgery were 14.46%(12/83)and 3.61%(3/83)in study group,which were significantly lower than the 33.73%(28/83)and 14.46%(12/83)in control group,and the differences were statistically significant(P<0.05).The occurrence of pain in1 week,1 month,3 months and 12 months after surgery were markedly less in study group compared to control group,with statistically significant difference noted(P<0.05).As to operative time,length of hospital stay,intraoperative blood loss,and number of lymph node dissection,as well as 1-and 3-year survival rate and local recurrence rate,and distant metastasis rate,there were no significant differences observed between the two groups(P>0.05).Conclusion The option of ICBN preservation during MRM-BC is conducive to reducing the occurrence of postoperative disturbance of skin sensation and scapular dyskinesia without compromising the quality of surgery,therefore achieving the desired short-term effect;and has demonstrated the advantage of long-term postoperative pain relief.Preservation of ICBN during surgery does not affect the 1-and 3-year survival rates of patients,with relatively low local recurrence and distant metastasis rate,and good long-term survival.
作者
刘峥
杨基鹏
任思媛
谢春华
LIU Zheng;YANG Jipeng;REN Siyuan;XIE Chunhua(Department of General Surgery,Zhuhai People’s Hospital,Zhuhai 519000,Guangdong,China)
出处
《癌症进展》
2020年第3期303-306,共4页
Oncology Progress
关键词
乳腺癌
肩关节功能
改良根治术
肋间臂神经
术后疼痛
breast cancer
shoulder function
modified radical mastectomy
intercostobrachial nerve
postoperative pain
