CAJ | 학술논문

目的：探讨保留肋间臂神经（ ICBN）在乳腺癌改良根治术中的临床意义。方法选择42例乳腺癌患者，完全随机化分组，观察组28例，行腋窝清扫时保留肋间臂神经；对照组14例，行腋窝清扫时切除肋间臂神经。观察组和对照组术后均常规治疗，进行严密观察随访，比较两组手术时间、腋窝淋巴结清扫数和局部复发、远处转移及生存率。结果对照组和观察组术后14 d、3个月、6个月上臂内侧感觉障碍发生率分别为85．7％、64．3％、50．0％和10．7％、3．5％、0．0％，差异均有统计学意义（χ2＝23．867、18．966、16．800，均P＜0.05）；对照组和观察组手术平均时间分别为（80．0±12．9） min和（88．0±15．6） min，腋窝淋巴结清扫平均数分别为（16．4±5．4）个和（14．8±6．1）个，两组差异均无统计学意义（均P＞0．05）；对照组局部复发、远处转移及生存率分别为0．0％、7．0％、0．0％，观察组分别为0．0％、7．0％、0．0％，两组差异均无统计学意义（均P＞0．05）。结论在乳腺癌改良根治术中保留肋间臂神经是可行的，保存了患侧上臂内侧及腋部皮肤的感觉功能，提高了患者生活质量。
목적：탐토보류륵간비신경（ ICBN）재유선암개량근치술중적림상의의。방법선택42례유선암환자，완전수궤화분조，관찰조28례，행액와청소시보류륵간비신경；대조조14례，행액와청소시절제륵간비신경。관찰조화대조조술후균상규치료，진행엄밀관찰수방，비교량조수술시간、액와림파결청소수화국부복발、원처전이급생존솔。결과대조조화관찰조술후14 d、3개월、6개월상비내측감각장애발생솔분별위85．7％、64．3％、50．0％화10．7％、3．5％、0．0％，차이균유통계학의의（χ2＝23．867、18．966、16．800，균P＜0.05）；대조조화관찰조수술평균시간분별위（80．0±12．9） min화（88．0±15．6） min，액와림파결청소평균수분별위（16．4±5．4）개화（14．8±6．1）개，량조차이균무통계학의의（균P＞0．05）；대조조국부복발、원처전이급생존솔분별위0．0％、7．0％、0．0％，관찰조분별위0．0％、7．0％、0．0％，량조차이균무통계학의의（균P＞0．05）。결론재유선암개량근치술중보류륵간비신경시가행적，보존료환측상비내측급액부피부적감각공능，제고료환자생활질량。
Objective To study the clinical significance of intercostobrachial nerve ( ICBN) reservation in radical resection of breast cancer .Methods 42 cases with breast cancer at stageⅠ,ⅡorⅢa were randomly divided into experimental group(n=28) and control group(n=14).In the experimental group,the ICBN were preserved in the axillary lymph node dissection operation ,while in the control group ,the ICBN were resected in the operation .After the operation,both two groups were treated as breast cancer and the patients were followed up .The operation time,the number of ALND , local tumor recurrence and distant metastasis rates after operation , survival rate were compared between the two groups.Results Postoperative 14 days,3 months and 6 months,the incidence rates of the sensory disorder in the internal upper arms in the control group were 85.7%,64.3% and 50.0% respectively,those in the experimental group were 10.7%,3.5% and 0.0%.The differences were statistically significant between the two groups(P<0.05).The average operation time,average number of lymph node dissection between control group and experimental group had no significant difference [(80.0 ±12.9) min vs (88.0 ±15.6) min,(16.4 ±5.4) vs (14.8 ±6.1)](P >0.05).In the control group,the local recurrence rate,distant metastasis rate and survival rate were 0.0%,7.0%and 0.0%,those in the experimental group were 0.0%,0.0% and 0.0%.There were no statistically significant differences between the two groups .Conclusion It is feasible to preserve the ICBN in radical resection of breast cancer ,which reserves the skin sensory function of the internal upper arm and axilla ,and enhance the patients'quality of life.