摘要
目的探讨保留胸前神经(ATN)和肋间臂神经(ICBN)改良乳腺癌根治术对早期乳腺癌患者的影响。方法选取106例早期乳腺癌患者,按随机数字表法分为2组,均53例。所有患者均行改良乳腺癌根治术,观察组术中保留ATN与ICBN,对照组术中未保留。比较2组手术相关指标、患侧肢体活动度、免疫功能、生活质量、并发症、复发转移情况。结果观察组手术时间为(87.96±8.32)min,长于对照组的(80.53±6.37)min;观察组住院时间为(5.30±1.22)d,短于对照组的(6.71±1.59)d;观察组并发症发生率为3.77%(2/53),低于对照组的15.09%(8/53)。术后观察组患侧肩关节后伸、外展、前屈活动度高于对照组。术后观察组CD3^(+)、CD4^(+)高于对照组,CD8^(+)低于对照组(P<0.05)。术后观察组生命质量测定量表(FACT-B)内各维度评分高于对照组(P<0.05)。2组复发转移率差异无统计学意义(P>0.05)。结论改良乳腺癌根治术中保留ATN与ICBN虽然会延长手术时间,但更能够减轻对早期乳腺癌患者患侧肢体活动度与免疫功能的影响,有助于患者生活质量的提高,且并发症少,值得临床借鉴。
Objective To analyze the effect of modified radical mastectomy with preservation of thoracic nerve(ATN)and intercostal brachial nerve(ICBN)on patients with early breast cancer.Methods 106 patients with early breast cancer were selected and divided into 2 groups according to the random number table.All patients underwent modified radical mastectomy.ATN and ICBN were preserved in the observation group,but not in the control group.Compare the 2 groups of surgical related indicators,affected limb mobility,immune function,quality of life,complications,recurrence and metastasis.Results The observation group had a surgery time of(87.96±8.32)minutes,which was longer than the control group's(80.53±6.37)minutes;The hospitalization time of the observation group was(5.30±1.22)days,which was shorter than that of the control group(6.71±1.59)days;The incidence of complications in the observation group was 3.77%(2/53),which was lower than the 15.09%(8/53)in the control group.The postoperative observation group had higher range of motion for the affected shoulder joint,including extension,abduction,and flexion,compared to the control group.The postoperative observation group had higher levels of CD3^(+)and CD4^(+)compared to the control group,and lower levels of CD8^(+)compared to the control group(P<0.05).The scores of each dimension in the FACT-B quality of life measurement scale in the postoperative observation group were higher than those in the control group(P<0.05);There was no significant difference in the recurrence and metastasis rates between the 2 groups,there had no statistical significance(P>0.05).Conclusion The retention of ATN and ICBN during modified radical mastectomy can prolong the operation time,but it can reduce the impact on the limb activity and immune function of the patients with early breast cancer,contribute to the improvement of the quality of life,and have fewer complications,which is worthy of clinical reference.
作者
杨银成
李贺
王玉玺
张明政
YANG Yincheng;LI He;WANG Yuxi(Zhang Zhongjing Hospital,Nanyang,473000)
出处
《实用癌症杂志》
2025年第9期1446-1449,共4页
The Practical Journal of Cancer
关键词
早期乳腺癌
改良乳腺癌根治术
胸前神经
肋间臂神经
Early breast cancer
Modified radical mastectomy
Thoracic nerve(ATN)
Intercostal brachial nerve(ICBN)
