2018 年第 7 期 第 13 卷

保留肋间臂神经乳腺癌根治术对患者生活质量及生存时间的影响

Effect of preserving intercostobrachial nerve in modified radical mastectomy of breast cancer on life quality and survival

作者：黄亚琼赵庆丽乔如丽柴凡

英文作者：

单位：730050兰州军区兰州总医院乳腺科

英文单位：

关键词：乳腺癌根治；肋间臂神经；生活质量；生存时间

英文关键词：

• 摘要：

• 【摘要】目的    探讨保留肋间臂神经乳腺癌根治术对患者术后生活质量及生存时间的影响。方法    选择2010年1月至2015年6月兰州军区兰州总医院收治的乳腺癌患者80例，按照随机数字表法分为观察组和对照组，各40例。对照组实施常规乳腺癌改良根治术，观察组实施保留肋间臂神经的改良根治术。比较2组手术时间、清扫淋巴结数量、术中出血量、术后1、3个月肋间及前臂感觉异常面积、术后1年复发或转移率及存活率。结果    2组患者手术时间比较，差异无统计学意义（P＞0.05）。观察组清扫淋巴结数量和术中出血量少于对照组［（11.5±2.1）个比（12.9±2.6）个、（185±21）ml比（209±25）ml］，差异均有统计学意义（均P＜0.05）。观察组术后1个月及术后3个月的肋间及前臂感觉异常面积均明显小于对照组［（4.12±0.71）cm2比（14.31±2.83）cm2，（2.43±0.20）cm2比（7.93±1.91）cm2］，差异均有统计学意义（均P＜0.001）。观察组术后1年复发或转移率明显低于对照组，存活率明显高于对照组［7.5%（3/40）比40.0%（16/40），95.0%（38/40）比67.5%（27/40）］，差异均有统计学意义（均P＜0.05）。结论    保留肋间臂神经的乳腺癌改良根治术能有效提高患者术后生活质量，且延长术后生存时间。

• 【Abstract】Objective    To investigate the effect of preserving intercostobrachial nerve in modified radical mastectomy of breast cancer on life quality and survival. Methods    Totally 80 mammary cancer patients admitted at Lanzhou Military Region General Hospital from January 2010 to June 2015 were randomly divided into observation group and control group, with 40 cases in each group. The control group was treated with conventional modified radical mastectomy; the observation group was treated with modified radical mastectomy with preservation of intercostobrachial nerve. Operation time, lymph node dissection number, intraoperative blood loss volume, postoperative intercostal and forearm paresthesia area, recurrence rate, metastasis rate and survival rate were analyzed. Results    Operation time had no significant difference between groups（P＞0.05）. Lymph node dissection number and intraoperative blood loss volume in observation group were significantly less than those in control group［（11.5±2.1） vs （12.9±2.6）, （185±21）ml vs （209±25）ml］（P＜0.05）. Intercostal and forearm paresthesia area in observation group was significantly smaller than that in control group 1, 3 months after operation［（4.12±0.71）cm2 vs （14.31±2.83）cm2, （2.43±0.20）cm2 vs （7.93±1.91）cm2］（P＜0.001）. One year recurrence/metastasis rate in observation group was significantly lower and survival rate was significantly higher than those in control group［7.5%（3/40） vs 40.0%（16/40）， 95.0%（38/40） vs 67.5%（27/40）］（P＜0.05）. Conclusion    Preservation intercostobrachial nerve in modified radical mastectomy of breast cancer is beneficial for patients' quality of life and postoperative survival time.

  【Key words】Radical mastectomy of breast cancer；Intercostobrachial nerve;Quality of life；Survival time