乳腺癌患者保留肋间臂神经临床意义.docVIP

乳腺癌患者保留肋间臂神经临床意义 　【摘要】; 目的:探讨乳腺癌腋窝淋巴结清扫术保留肋间臂神经的价值。方法：对天津医科大学附属肿瘤医院20001~200112月间69例保留肋间臂神经和34例切除肋间臂神经的乳腺癌患者进行随访。结果：肋间臂神经保留组术后48例无感觉方面上的变化，11例发生感觉麻木，1例上肢出现烧灼感，9例上肢出现感觉减退；而肋间臂神经切除组术后3例出现腋窝无汗，18例发生感觉麻木，4例上肢出现烧灼感，9例上肢出现感觉减退。两组之间在统计学上有显著性差异（chi;2=481570；P＜005）；肋间臂神经保留组58例术后未发生患肢疼痛，11例发生患肢疼痛；而肋间臂神经切除组5例术后未发生患肢疼痛，29例术后发生患肢疼痛。两组患者之间在统计学上有显著性差异（chi;2=461194；P＜005）。结论：乳腺癌患者保留肋间臂神经可以明显减少术后患侧上肢感觉障碍和疼痛的发生，从而提高患者的生活质量。 ; 【关键词】; 乳腺癌；肋间臂神经；腋淋巴结清扫 ; 【ABSTRACT】; Objective：: To investigate the clinical significance of reserving intercostobrachial nerve during axillary dissection for breast cancer.Method: From January 2000 to December 2001, 69 patients with breast cancer were reservation intercostobrachial nerve and 34 patients were not.All of them were followed up for 3 years.Results: In the group of reservating intercostobrachial nerve, 48 patients have no change in sensation, 11 patients have anesthesia, one has burning sensation, and 9 patients have hypoaesthesia.But in the group of resecting intercostobrachial nerve, 3 patients have axillary absent sweating, 18 patients have anesthesia, 4 patients have burning sensation, and 9 patients have hypoaesthesia.There is significant difference between the two groups（chi;2=481570; P＜005）; In the group of reservation intercostobrachial nerve, 58 patients have no pain feeling in the affected limb, and 11 patients have pain feeling in the affected limb But in the group of resecting intercostobrachial nerve, 5 patients have no pain feeling in the affected limb, and 29 patients have pain feeling in the affected limbThere is significant difference between the two groups（chi;2=461194; P＜005）.Conclusin: Reserving intercostobrachial nerve during breast cancer operation could significantly decrease the incidence of sensory disability and pain in the affacted limb, and improve the quality of life for patients with breast cancer ; 【KEY WORDS】; Breast cancer;Intercostobrachial nerve; Axillary lymph nodes resection ; 随着乳腺癌患者对生活质量要求的提高，保留肋间臂神经的手术正逐渐