目的:探讨乳腺癌前哨淋巴结活检术(sentinel lymph node biopsy,SLNB)中保留肋间臂神经(intercostobrachial nerve,ICBN)的可行性.方法:回顾性分析乳腺癌前哨淋巴结活检术患者184例,其中50例行保留ICBN的SLBN,134例行切除ICBN的SLBN.比较两组的手术时间、出血量、清扫淋巴结数目及术后切口合并症;记录SLNB后术侧上臂和腋窝疼痛及感觉异常情况及转归.结果:保留ICBN组与非保留组比较,手术时间、出血量、淋巴结清扫数目及术后切口合并症比较差异无统计学意义.保留组及非保留组术侧上臂、腋窝的疼痛及感觉情况发生率近3天差异无统计学意义.而腋窝及上臂内侧区皮肤感觉异常术后0.5~3个月比较差异有统计学意义,且术后3个月非保留组的患侧腋窝及上臂内侧区皮肤感觉异常的缓解率较差,差异有统计学意义.结论:乳腺癌SLNB中保留ICBN的术式不增加手术难度,可减少患者术后术侧腋窝及上臂疼痛、感觉异常的发生率,能保持患者术后高质量的生活,保留ICBN的乳腺癌SLNB是安全可行的.%Objective: To investigate the feasibility of preserving the intercostal nerve (ICBN) in sentinel lymph node biopsy (SLNB) of breast cancer.Methods: A retrospective analysis of 184 patients with breast cancer sentinel lymph node biopsy was performed. ICBN was performed in all the patients, and 134 patients underwent sentinel lymph node biopsy (ICBN). The operation time, blood loss, number of lymph nodes and postoperative complications were compared between the two groups, and the skin paresthesia, pain and prognosis of the patients with axillary and medial upper arm were observed.Results: There was no signiflcant diflerence in operation time, blood loss, number of lymph node dissection and postoperative complications between the ICBN group and the control group. There was no statistically signiflcant diflerence in the incidence of abnormal sensation in the armpit and upper arm in 3 days afler operation. While the upper medial arm and axilla skin paresthesia afler 0.5-3 months had signiflcant diflerence, preserve the ipsilateral upper medial arm and axilla skin paresthesia group lower rates of remission 3 months afler operation and ICNB, the diflerence was statistically signiflcant.Conclusion: SLNB of ICBN preservation in breast cancer does not increase the difficulty of operation. It can reduce patient's postoperative side arm paresthesia and the incidence of pain, can improve the quality of life of patients afler operation, SLNB of ICBN preservation in breast cancer is safe and feasible.
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