乳腺癌保乳手术中保留肋间臂神经疗效分析.docVIP

乳腺癌保乳手术中保留肋间臂神经疗效分析 　　[摘要] 目的 探讨乳腺癌保乳手术中保留肋间臂神经的疗效。 方法 将我院收治的40例乳腺癌患者分为治疗组和对照组，两组均采用保乳手术治疗，对照组在术中常规切除肋间臂神经，治疗组保留肋间臂神经，比较两组的临床疗效。 结果 40例患者术后均随访6～36个月，均未见复发、转移、死亡。治疗组的患者患侧肢体感觉障碍及疼痛的情况显著优于对照组（P＜0.05）。 结论 乳腺癌保乳手术中保留肋间臂神经能明显减轻上肢感觉障碍及疼痛，促进患者生活质量的提高。 　　[关键词] 乳腺癌；保乳术；肋间臂神经；疗效 　　[中图分类号] R737.9 [文献标识码] B [文章编号] 1673-9701（2012）01-134-02 　　 　　Clinical efficacy analysis on preserve the intereostobrachial nerve after breast-conserving surgery for breast carcinoma 　　YANG Guanmin 　　General Surgery Department in First Peoples Hospital of Yanzhou City, Shandong Province, Yanzhou 272100, China 　　 　　[Abstract] Objective To investigate clinical efficacy analysis on preserve the intereostobrachial nerve after breast-conserving surgery for breast carcinoma. Methods All of 40 cases of breast cancer in our hospital were randomly divided into treatment group and control group, they were all given breast-conserving surgery, the control group was removed the intercostal nerve during surgery, while the treatment group was preserved the intereostobrachial nerve. Two groups were compared by clinical curative effect. Results After 40 patients were followed up for 6 to 36 months, they were showed no recurrence, metastasis, and death. Affected limb sensory disturbances and pain in the treatment group was significantly better than the control group (P＜0.05). Conclusion Retain breast conserving surgery can significantly reduce the intercostal nerve during upper extremity sensory disturbances and pain, and improve the patients quality of life. 　　[Key words] Breast cancer; Breast-conserving surgery; Intereostobrachial nerve; Effect 　　 　　乳腺癌是最常见的女性恶性肿瘤之一，严重威胁患者的健康。目前改良根治术仍是治疗乳腺癌Ⅰ、Ⅱ期的主要方式。但传统乳腺癌改良根治术常切除肋间臂神经，患者术后出现明显的上臂内侧感觉障碍及疼痛[1，2]，生活质量受到较大的影响。近年来，随着??创手术的发展和患者对术后生活质量要求的提高，保留肋间臂神经的手术已逐渐被越来越广泛地应用。我院在20例乳腺癌保乳手术中保留肋间臂神经，疗效满意，现报道如下。 　　 　　1 资料与方法 　　1.1 一般资料 　　选取我院2008年12月～2009年8月收治的40例经病理组织学检查确诊的乳腺癌患者为研究对象，均为女性，年龄23～40岁，平均（34.5±4.5）岁；根据国际抗癌协会建议的TNM分期法，Ⅰ期4例，Ⅱ期22例，Ⅲa期14例。其中浸润性导管癌34例，黏液癌4例，腺癌2例