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目的探讨乳腺癌根治术保留胸前神经及肋间臂神经的临床效果。方法乳腺癌患者106例,保留胸前神经及肋间臂神经53例为观察组,行乳腺癌根治术未保留胸前神经及肋间臂神经53例为对照组,比较2组手术时间,观察2组治疗后相关指标变化。结果观察组手术时间[(105.12±10.85)min]与对照组[(103.23±11.42)min]比较差异无统计学意义(P>0.05);观察组术后转移率(11.32%)、复发率(9.43%)及上肢水肿、上臂感觉障碍、上臂运动障碍、胸大肌萎缩发生率(7.55%、1.89%、1.89%、3.77%)均低于对照组(24.53%、26.41%、11.32%、7.55%、7.55%、13.21%)(P<0.05);2组治疗后躯体功能、角色功能、社会功能、情绪功能评分均较术前增高(P<0.05),且观察组治疗后躯体功能、角色功能、社会功能、情绪功能评分(59.98±7.13、65.22±6.74、62.82±5.43、56.39±6.39)明显高于对照组(52.13±6.42、59.75±5.17、51.63±4.38、45.75±6.15),差异均有统计学意义(P<0.05)。结论乳腺癌根治术保留胸前神经及肋间臂神经可降低术后转移率、复发率、并发症发生率,提高患者术后生活质量。
Objective To investigate the clinical efficacy of radical mastectomy for the preservation of the anterior thoracic nerve and intercostobrachial nerve. Methods 106 cases of breast cancer patients, the preservation of the thoracic nerve and intercostobrachial nerve in 53 cases as the observation group, underwent radical mastectomy without preserving the chest nerve and intercostobrachial nerve in 53 cases as control group, compared the two groups of operation time and observation 2 groups after treatment related indicators change. Results There was no significant difference between the observation group and the control group [(105.12 ± 10.85) min vs (103.23 ± 11.42) min] (P> 0.05). The postoperative metastasis rate was 11.32% 9.43%), upper extremity edema, upper arm sensory disturbance, upper arm dysfunction and pectoralis major atrophy (7.55%, 1.89%, 1.89%, 3.77%) were lower than those in the control group (24.53%, 26.41%, 11.32%, 7.55% %, 7.55%, 13.21%, respectively) (P <0.05). After treatment, the body function, role function, social function and emotional function score of the two groups were significantly higher than those before operation (P <0.05) (59.98 ± 7.13,65.22 ± 6.74,62.82 ± 5.43,56.39 ± 6.39) was significantly higher than that of the control group (52.13 ± 6.42,59.75 ± 5.17,51.63 ± 4.38,45.75 ± 6.15), the difference was significant There was statistical significance (P <0.05). Conclusion Radical mastectomy for breast cancer preserving the anterior chest nerve and intercostobrachial nerve can reduce postoperative metastasis rate, recurrence rate and complication rate, and improve postoperative quality of life.