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乳腺癌改良根治术中保留胸前神经和肋间臂神经对患者术后并发症及复发的影响 被引量:16

Effects of Preserving Nervi Thoracales Anteriores and Intercostobrachial Nerves in Modified Radical Mastectomy for Patients with Breast Cancer on Postoperative Complications and Recurrence
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摘要 目的探讨乳腺癌改良根治术中保留胸前神经和肋间臂神经病灶切除治疗对乳腺癌患者术后并发症、复发及乳房美观度的影响。方法选择2016年1月—2020年1月收治的乳腺癌104例,按照手术方法分为研究组56例和对照组48例。研究组给予乳腺癌改良根治术中保留胸前神经和肋间臂神经,对照组给予常规乳腺癌改良根治术。比较2组手术相关指标、术后并发症、乳房美观度、复发、转移及生存情况。结果研究组手术时间长于对照组,住院时间短于对照组(P<0.05)。研究组上肢水肿、感觉障碍、腋窝疼痛、肌肉萎缩、皮下积液、皮瓣坏死发生率低于对照组,乳房表面美观评分高于对照组(P<0.05)。2组转移及生存情况比较差异无统计学意义(P>0.05);研究组复发率低于对照组(P<0.05)。结论乳腺癌改良根治术中保留胸前神经和肋间臂神经可有效降低乳腺癌患者术后复发率及并发症发生率,提升乳房美观度。 Objective To explore effects of preserving nervi thoracales anteriores and intercostobrachial nerves in modified radical mastectomy for patients with breast cancer on postoperative complications,recurrence and breast aesthetics.Methods A total of 104 patients with breast cancer admitted between January 2016 and January 2020 were selected,and the patients were divided into research group(n=56)and control group(n=48)according to surgical methods.Research group was given preservation of nervi thoracales anteriores and intercostobrachial nerves during modified radical mastectomy for breast cancer,while control group was given conventional modified radical mastectomy.Surgery-related indicators,conditions of postoperative complications,breast aesthetics,recurrence,metastasis and survival were compared between two groups.Results Compared with those in control group,operative duration was significantly longer,while the length of stay was significantly shorter in research group(P<0.05).Compared with those in control group,incidence rates of upper extremity edema,sensory disturbance,axillary pain,muscle atrophy,subcutaneous hydrops and skin flap necrosis were significantly lower,while the breast surface beautiful score(BSBs)was significantly higher in research group(P<0.05).There were no significant differences in metastasis and survival conditions between two groups(P>0.05).The recurrence rate in research group was significantly lower than that in control group(P<0.05).Conclusion Preservation of nervi thoracales anteriores and intercostobrachial nerves in modified radical mastectomy may effectively decease the recurrence rate and incidence rate of complications and improve breast aesthetics in patients with breast cancer after surgery.
作者 秦雪 刘广舒 张全刚 QIN Xue;LIU Guang-shu;ZHANG Quan-gang(Department of Oncology,People's Hospital of Langfang City,Langfang,Hebei 065000,China;Department of Interventional Vascular Surgery,People's Hospital of Langfang City,Langfang,Hebei 065000,China)
出处 《解放军医药杂志》 CAS 2021年第12期34-37,共4页 Medical & Pharmaceutical Journal of Chinese People’s Liberation Army
基金 河北省医学科学研究重点课题计划项目(20190613)。
关键词 乳腺肿瘤 乳房切除术 改良根治性 手术后并发症 肿瘤复发 肿瘤转移 预后 Breast neoplasms Mastectomy,modified radical Postoperative complications Neoplasm recurrence Neoplasm metastasis Prognosis
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