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目的:探讨乳腺癌腔镜腋窝淋巴结清扫术(EALND)中保留肋间臂神经(ICBN)的方法及意义。方法:收集2010年4月—2012年9月98例行EALND的I,II期乳腺癌患者临床资料,将其中52例保留ICBN患者资料(保留组)与早期46例未保留ICBN患者资料(未保留组)进行对照分析。结果:保留组术后上臂皮肤感觉异常(麻木和/或疼痛)发生率为7.69%(4/52),未保留组为82.61%(38/46),两组差异有统计学意义(P<0.05)。未保留ICBN组中38例上臂皮肤感觉异常症状持续1年以上,保留组4例症状较未保留组轻微,其中3例3个月内症状完全缓解,1例6个月内症状完全缓解。结论:充分吸脂是乳腺癌EALND保留ICBN的关键,保留ICBN能够减少术后患侧上肢麻木和/或疼痛的发生,提高患者生活质量。
Objective: To explore the method and significance of preserving intercostobrachial nerve (ICBN) in endoscopic axillary lymph node dissection (EALND) of breast cancer. Methods: The clinical data of 98 patients with stage I and II breast cancer who underwent EALND from April 2010 to September 2012 were collected. The data of 52 patients with ICBN preserved (reserved group) and 46 patients with unreserved ICBN Retention group) for comparative analysis. Results: The incidence of postoperative upper arm skin sensation (numbness and / or pain) was 7.69% (4/52) in the retention group and 82.61% (38/46) in the non - retention group, with significant difference between the two groups (P < 0.05). In the unreserved ICBN group, 38 cases of upper extremity skin sensory abnormalities persisted for more than one year. Four cases in the reserved group had less symptoms than the non-reserved group, of which 3 cases were completely relieved within 3 months and 1 case completely relieved within 6 months. Conclusion: Liposuction is the key to retain ICBN in EALND for breast cancer. Preserving ICBN can reduce numbness and / or pain in upper limbs and improve patient quality of life.