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目的探讨乳腺癌腋窝淋巴结清扫术中保留肋间臂神经的临床效果。方法选择我院乳腺癌患者共82例,上述患者分为观察组和对照组。观察组和对照组患者均根据患者情况实施乳腺癌改良根治术、乳腺癌保乳切除联合腋窝淋巴结清扫术。在手术过程中,观察组对肋间臂神经进行保护,而对照组对肋间臂神经没有进行保护。记录两组患者术后3d、术后30d、术后90d及术后180d患侧上臂内侧和腋窝皮肤感觉障碍情况,局部皮肤有麻木、疼痛、烧灼等不适感觉即可评定为感觉障碍。结果观察组术后术后3d、术后30d、术后90d和术后180d感觉障碍发生率分别与对照组比较,差异有统计学意义(P<0.05)。结论乳腺癌腋窝淋巴结清扫术中保留肋间臂神经可以有效的减少患侧术后腋窝和上臂内侧皮肤感觉障碍发生率,效果显著,值得借鉴。
Objective To investigate the clinical effect of preserving intercostobrachial nerve in axillary lymph node dissection of breast cancer. Methods A total of 82 patients with breast cancer in our hospital were selected. The above patients were divided into observation group and control group. Patients in the observation group and the control group were treated with radical mastectomy for breast cancer, breast-conserving excision combined with axillary lymph node dissection. During the operation, the observation group protected the intercostobrachial nerve while the control group did not protect the intercostobrachial nerve. The sensory disturbances were recorded in the two groups at 3d, 30d, 90d and 180d after operation. The sensory disturbance was found in the medial upper arm and the armpit skin of the two groups. Numbness, pain, burning and other discomfort were found on the local skin. Results The incidence of sensory disturbance in observation group after operation for 3 days, 30 days, 90 days and 180 days after operation were significantly higher than those in control group (P <0.05). CONCLUSION: The preservation of intercostobrachial nerve during axillary lymph node dissection in breast cancer can effectively reduce the incidence of skin sensation in the axilla and medial arm after operation. The results are worthy of reference.