乳腺癌改良根治术保留肋间臂神经对患者感觉变化及生活质量影响
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摘要
目的探讨乳腺癌行改良根治术患者行腋窝淋巴结清扫时保留肋间臂神经(ICBN)的临床价值.方法根据数字表法及患者意愿将行改良根治术的60例乳腺癌患者分为研究组(保留ICBN)及对照组,比较两组患者术后感觉变化及生存质量的差异.结果两组患者在术后1个月、术后3个月、术后6个月感觉迟钝、感觉异常方面比较差异无统计学意义(P>0. 05).两组患者触觉变化在术后6个月开始有差异(P<0. 05),两组患者痛觉变化在术后3个月、术后6个月均有差异(P<0. 05),研究组患者的腋窝触觉与痛觉面积减退更加明显.结论在行乳腺癌改良根治术患者中保留ICBN具有长期腋窝触觉及痛觉面积减退的优点,可改善患者术后的生存质量.
Objective To investigate the clinical value of preserving ICBN in patients with modified radical mastectomy for axillary lymph node dissection. Method According to the digital table method and patients' wishes,60 patients with breast cancer treated by modified radical mastectomy were divided into study group(retention of ICBN) and control group. The differences in sensory and quality of life between the two groups were compared. Results There was no significant difference between two groups in 1 month,3 months and 6 months postoperatively,and no significant difference in sensation(P>0. 05). The change of tactile sensation between two groups began to be different in 6 months after operation(P<0. 05). The change of pain sensation in both groups was different in 3 months and 6 months after operation(P < 0. 05). Tactile and painful area decreased more pronounced. Conclusion The preservation of ICBN in patients undergoing modified radical mastectomy has the advantage of prolonged axillary and painful area reduction,and improves the postoperative quality of life.
Objective To investigate the clinical value of preserving ICBN in patients with modified radical mastectomy for axillary lymph node dissection. Method According to the digital table method and patients' wishes,60 patients with breast cancer treated by modified radical mastectomy were divided into study group(retention of ICBN) and control group. The differences in sensory and quality of life between the two groups were compared. Results There was no significant difference between two groups in 1 month,3 months and 6 months postoperatively,and no significant difference in sensation(P>0. 05). The change of tactile sensation between two groups began to be different in 6 months after operation(P<0. 05). The change of pain sensation in both groups was different in 3 months and 6 months after operation(P < 0. 05). Tactile and painful area decreased more pronounced. Conclusion The preservation of ICBN in patients undergoing modified radical mastectomy has the advantage of prolonged axillary and painful area reduction,and improves the postoperative quality of life.
引文
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[11] Zhao J,Su F,Hu Y,et al. Prospective comparison of Sapylin and Avitene for reducing hydrops after axillary lymphadenectomy in breast cancer patients[J]. Journal of Surgical Research,2017,210(4):8-14.
[2]程少萍.Ⅰ期和Ⅱ期乳腺癌保乳手术与改良根治术的临床随机对照研究[J].中国实用医药,2017,12(25):36-38.
[3]黄炜,王亚兵,殷照才,等.简化腋窝淋巴结清扫术在早期乳腺癌治疗中的应用[J].中国肿瘤外科杂志,2015,7(2):83-85.
[4]郑桓,唐照鹏,陈源水,等.探讨乳腺癌腋窝淋巴结清扫术后感觉异常的解剖学机制[J].重庆医学,2015,44(18):2451-2453.
[5]郭明伟.乳腺癌改良根治术中保留肋间臂神经的临床观察[J].中国卫生标准管理,2018,9(7):46-47.
[6]叶明明,胡文军,孙翠玲,等.乳腺癌化疗患者生存质量测定表考评QLICP-BR版评估[J].安徽医药杂志,2009,13(5):546-547.
[7]郑向欣,管小青,吴骥,等.溶脂辅助保留肋间臂神经在乳腺癌术中的临床意义[J].现代肿瘤医学,2015,23(19):2769-2773.
[8]李志扬,孟玮玮,蔡道全,等.精细解剖保留肋间臂神经在乳腺癌改良根治术中的价值[J].山东医药,2016,56(13):73-75.
[9]傅少梅,殷初阳,宋晖.保留肋间臂神经对乳腺癌腋窝淋巴结清扫术的感觉障碍影响的研究[J].国际生物医学工程杂志,2016,39(3):188-190.
[10]薛治国.乳腺癌改良根治术保留肋间臂神经对患者术后恢复及生存率的影响[J].河南医学研究,2016,25(10):1859-1860.
[11] Zhao J,Su F,Hu Y,et al. Prospective comparison of Sapylin and Avitene for reducing hydrops after axillary lymphadenectomy in breast cancer patients[J]. Journal of Surgical Research,2017,210(4):8-14.