切换至 "中华医学电子期刊资源库"

中华普外科手术学杂志(电子版) ›› 2019, Vol. 13 ›› Issue (05) : 525 -527. doi: 10.3877/cma.j.issn.1674-3946.2019.05.030

所属专题: 文献

论著

不同手术治疗Ⅰ~Ⅱ期乳腺癌对保留肋间臂神经的影响比较
江卫兵1,()   
  1. 1. 242000 安徽省宣城市中心医院心胸乳腺外科
  • 收稿日期:2018-09-18 出版日期:2019-10-26
  • 通信作者: 江卫兵

Comparison of the effects of different surgical treatments for stage Ⅰ~Ⅱ breast cancer on the preservation of intercostobrachial nerve

Wei bing Jiang1,()   

  1. 1. Cardiothoracic surgery, Xuancheng Central Hospital, Anhui Province, 242000
  • Received:2018-09-18 Published:2019-10-26
  • Corresponding author: Wei bing Jiang
  • About author:
    Corresponding author: Jiang Weiping, Email:
引用本文:

江卫兵. 不同手术治疗Ⅰ~Ⅱ期乳腺癌对保留肋间臂神经的影响比较[J]. 中华普外科手术学杂志(电子版), 2019, 13(05): 525-527.

Wei bing Jiang. Comparison of the effects of different surgical treatments for stage Ⅰ~Ⅱ breast cancer on the preservation of intercostobrachial nerve[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2019, 13(05): 525-527.

目的

探究不同手术方法治疗Ⅰ~Ⅱ期乳腺癌对保留肋间臂神经( ICBN))的疗效。

方法

回顾性分析2016年1月至2018年1月72例早期乳腺癌患者,根据术式不同分为保乳组(n=38)与根治组(n=34),保乳组患者采取保乳手术治疗,根治组患者进行改良根治术治疗。采用SPSS19.0软件进行统计分析,围术期相关指标和术后乳腺功能评分等采用(±s)描述,独立t检验;术后并发症发生率及术后肢体感觉情况采用χ2检验分析,P<0.05差异有统计学意义。

结果

保乳组患者的手术时间、术中出血量、总引流量等围手术指标均明显少于根治组(P<0.05),淋巴结清扫数量两组差异无统计学意义(P>0.05);保乳组患者的并发症总发生率为10.5%,显著低于根治组患者的29.4%(P<0.05);保乳组患者的术后灼痛、麻木、疼痛、感觉减退等肢体感觉情况和乳腺功能评分明显好于根治组(P<0.05)。

结论

保乳手术对Ⅰ~Ⅱ期乳腺癌患者的疗效良好,能有效保留患者的ICBN,改善其乳腺功能,值得临床应用。

Objective

To investigate the effect of different surgical treatments for stage Ⅰ~Ⅱ breast cancer on the preservation of intercostobrachial nerve (ICBN).

Methods

72 patients with early breast cancer treated in our hospital from January 2016 to January 2018 were retrospectively analyzed. The patients were divided into breast-conserving group (n=38) and radical group (n=34) according to different surgical methods. Among them, patients in the breast-preserving group were treated with breast-conserving surgery, while those in the radical group were treated with modified radical mastectomy. The data were analyzed by SPSS19.0 software. The perioperative related indicators and postoperative mammary gland function scores were described by (±s) and compared with independent t test. The postoperative complication rate and postoperative limb sensation were described by (n, %), and compared with χ2 test. The difference was statistically significant when P<0.05.

Results

Compared with the radical group, the perioperative indexes such as operation time, intraoperative blood loss and total drainage volume were significantly lower in the breast-preserving group (P<0.05), but there was no significant difference in the number of lymph node dissection between the two groups(P>0.05). In addition, the total incidence of complications in the breast-preserving group was 10.5%, which was significantly lower than that in the radical group (29.4%) (P<0.05). The incidences of postoperative burning pain, numbness, pain, sensory loss and no sensory feelings of the patients in the breast-preserving group were significantly lower than those in the radical group (P<0.05). The scores of breast function in the postoperative breast-preserving group were significantly better than those in the radical group (P<0.05).

Conclusion

Breast-conserving surgery has a good therapeutic effect on patients with stage Ⅰ~Ⅱ breast cancer, which can effectively preserve the patient’s ICBN and improve its mammary gland function, which is worthy of clinical recommendation.

表1 72例早期乳腺癌不同术式两组患者的基本临床资料(例)
表2 72例早期乳腺癌不同术式两组患者手术指标比较(±s)
表3 72例早期乳腺癌不同术式两组患者术后并发症情况比较[例(%)]
表4 72例早期乳腺癌不同术式两组术后肢体感觉对比[例(%)]
表5 72例早期乳腺癌不同术式两组术后FACT-B量表评分比较(±s)
[1]
Sekiguchi K,Akahane K,Ogita M, et a1. Efficacy of heparinoid moisturizer as a prophylactic agent for radiation dermatitis following radiotherapy after breast-conserving surgery: a randomized controlled trial[J]. Jpn J Clin Oncol, 2018, 48(5): 450-457.
[2]
李翔.保乳手术和改良根治术治疗早期乳腺癌的临床疗效分析[J/CD]. 中华普外科手术学杂志(电子版), 2017, 11(3): 222-225.
[3]
郭方东.保乳术与改良根治术对早期乳腺癌的疗效及术后生存质量比较[J].中国现代普通外科进展,2016, 19(1): 62-63.
[4]
杨德全,王军胜,刘高星.保乳术与改良根治术治疗早期乳腺癌I临床对比研究[J]. 中国实用医药,2016, 11(19): 50-51.
[5]
易瑛,蒋雪梅,雷海,等.保乳手术与改良根治术对早期乳腺癌患者生活质量的影响[J]. 临床肿瘤学杂志,2016, 21(7): 638-641.
[6]
王妍,原晓燕,邱衍哲,等.保乳手术和改良根治手术在乳腺癌患者临床治疗的效果研究[J]. 现代生物医学进展,2016, 16 (24): 4759-4762.
[7]
Marrazzo A,Damiano G,Taormina P, et a1. Does conservative surgery for breast careinoula still require axillary lymph node evaluation?A retrospective analysis of 1156 consecutive women with early breast cancer[J]. Clin Breast Cancer, 2017, 17(2): e53-e57.
[8]
陈大榕.保乳术治疗早期乳腺癌的临床疗效观察[J]. 临床合理用药杂志,2016, 9(12A): 138-139.
[9]
陆海涛.早期乳腺癌保乳手术与改良根治术的临床对比研究[J]. 中国现代药物应用,2016, 10(6): 101-101, 102.
[10]
李众,袁阳春.保乳术与改良根治术治疗乳腺癌的Ⅰ临床疗效比较[J].中国临床新医学,2017, 10(1): 62-64.
[11]
彭莉娜,李征毅,陈伟财,等.保乳手术与改良根治术治疗早期乳腺癌的临床对照分析[J].中国实用医药,2017, 12(14): 57-58.
[12]
Nasr MW,Habre SB,Jabbour H, et al.A randomized controlled trial of postoperative pain control after subpectoral breast augmentation using intercostal nerve block versus bupivacaine pectoralis major infiltration: a pilot study [J]. J Plast Reconstr Aesthet Surg, 2015, 68(4): e83-e84.
[13]
赵冰,焦得闯,乔江华,等.保乳术与改良根治术治疗早期乳腺癌的效果及对患者术后生存质量的影响比较[J].河南医学研究,2017, 26(5): 806-807.
[14]
王芳,杜攀,刘磊,等.乳腺癌改良根治术与保乳术对乳腺癌患者存活质量、社会适应性及心理状态的影响[J].实用预防医学,2016, 23(10): 1236-1238.
[15]
祁峰.保留肋间臂神经在52例乳腺癌改良根治术中的临床应用效果观察[J]. 中国现代药物应用,2016, 10(2): 52-53.
[16]
伍传新,廖洪映,江泽勇,等.乳腺癌改良根治术保留肋间臂神经对患者预后的影响[J]. 海南医学,2018, 29(9): 1301-1302.
[17]
谌彪,刘新明,史新河. 保留肋间臂神经对乳腺癌术后患侧感觉的影响[J]. 中国现代普通外科进展,2017, 20(12): 978-979, 982.
[18]
杨忠义,李兰,柳朝晖,等. 保乳术与乳腺癌改良根治术对保留肋间臂神经的影响[J]. 中国现代手术学杂志,2018, 22(1): 14-17.
[1] 郏亚平, 曾书娥. 含鳞状细胞癌成分的乳腺化生性癌的超声与病理特征分析[J]. 中华医学超声杂志(电子版), 2023, 20(08): 844-848.
[2] 唐玮, 何融泉, 黄素宁. 深度学习在乳腺癌影像诊疗和预后预测中的应用[J]. 中华乳腺病杂志(电子版), 2023, 17(06): 323-328.
[3] 康夏, 田浩, 钱进, 高源, 缪洪明, 齐晓伟. 骨织素抑制破骨细胞分化改善肿瘤骨转移中骨溶解的机制研究[J]. 中华乳腺病杂志(电子版), 2023, 17(06): 329-339.
[4] 衣晓丽, 胡沙沙, 张彦. HER-2低表达对乳腺癌新辅助治疗疗效及预后的影响[J]. 中华乳腺病杂志(电子版), 2023, 17(06): 340-346.
[5] 施杰, 李云涛, 高海燕. 腋窝淋巴结阳性Luminal A型乳腺癌患者新辅助与辅助化疗的预后及影响因素分析[J]. 中华乳腺病杂志(电子版), 2023, 17(06): 353-361.
[6] 伍秋苑, 陈佩贤, 邓裕华, 何添成, 周丹. 肠道微生物在乳腺癌中的研究进展[J]. 中华乳腺病杂志(电子版), 2023, 17(06): 362-365.
[7] 谭巧, 苏小涵, 侯令密, 黎君彦, 邓世山. 乳腺髓样癌的诊治进展[J]. 中华乳腺病杂志(电子版), 2023, 17(06): 366-368.
[8] 周婉丽, 钱铮, 李喆. 槐耳在乳腺癌免疫治疗中的研究进展[J]. 中华乳腺病杂志(电子版), 2023, 17(06): 369-371.
[9] 熊倩, 罗凤. 乳腺癌患者术后康复现状与对策的研究进展[J]. 中华乳腺病杂志(电子版), 2023, 17(06): 372-374.
[10] 杨小菁, 姜瑞瑞, 石玉香, 王静静, 李长天. 乳腺孤立性纤维性肿瘤一例[J]. 中华乳腺病杂志(电子版), 2023, 17(06): 375-377.
[11] 晏晴艳, 雍晓梅, 罗洪, 杜敏. 成都地区老年转移性乳腺癌的预后及生存因素研究[J]. 中华普外科手术学杂志(电子版), 2023, 17(06): 636-638.
[12] 李智铭, 郭晨明, 庄晓晨, 候雪琴, 高军喜. 早期乳腺癌超声造影定性及定量指标的对比研究[J]. 中华普外科手术学杂志(电子版), 2023, 17(06): 639-643.
[13] 莫波, 王佩, 王恒, 何志军, 梁俊, 郝志楠. 腹腔镜胃癌根治术与改良胃癌根治术治疗早期胃癌的疗效[J]. 中华普外科手术学杂志(电子版), 2023, 17(06): 644-647.
[14] 索郎多杰, 高红桥, 巴桑顿珠, 仁桑. 腹腔镜下不同术式治疗肝囊型包虫病的临床疗效分析[J]. 中华普外科手术学杂志(电子版), 2023, 17(06): 670-673.
[15] 唐浩, 梁平, 徐小江, 曾凯, 文拨辉. 三维重建指导下腹腔镜右半肝加尾状叶切除治疗Bismuth Ⅲa型肝门部胆管癌的临床研究[J]. 中华普外科手术学杂志(电子版), 2023, 17(06): 688-692.
阅读次数
全文


摘要