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目的探讨乳腺癌腋窝淋巴结清扫术中保留肋间臂神经(ICBN)的临床价值。方法回顾性分析了我院、奎屯农七师医院及新疆肿瘤医院262例Ⅰ、Ⅱ期乳腺癌患者,随机分成两组(ICBN保留组112例及ICBN切除组150例),比较两组术后的皮肤感觉、清扫淋巴结数目、手术时间、术中出血等临床资料。结果:保留组在手术时间多于切除组;在术中出血量、清扫淋巴结个数与切除组相比差异无统计学意义(P>0.05);保留组在1、3、6月术后上臂内侧皮肤感觉障碍明显好于切除组,差异有统计学意义(P<0.05);在复发和转移方面与切除组相比差异无统计学意义。结论:乳腺癌腋窝淋巴结清扫术中保留肋间臂神经,虽增加手术时间,但能减少术后患者上肢感觉异常,而不增加术后复发率。
Objective To investigate the clinical value of preserving intercostobrachial nerve (ICBN) in axillary lymph node dissection of breast cancer. Methods We retrospectively analyzed 262 cases of stage Ⅰ and Ⅱ breast cancer in our hospital, 7th Hospital of Kuitunong and Xinjiang Cancer Hospital. All patients were randomly divided into two groups (ICBN retention group, 112 cases and ICBN resection group, 150 cases) The skin feeling, the number of lymph node dissection, operation time, intraoperative bleeding and other clinical data. Results: The retention time was longer in the operation group than in the resection group. There was no significant difference in the amount of bleeding and the number of lymph nodes between resection group and the resection group (P> 0.05) The medial skin sensory disturbance was significantly better than that in the resection group (P <0.05). There was no significant difference between resection group and recurrence and metastasis. CONCLUSION: The intercostobrachial nerve remains in the axillary lymph node dissection of breast cancer. Although it increases the operation time, it can reduce the sensation of upper extremity in postoperative patients without increasing the recurrence rate.