目的：探讨乳腺癌乳腔镜腋窝淋巴结清扫术中保留肋间臂神经的临床意义。方法选择70例乳腺癌患者为研究对象，根据是否保留肋间臂神经将其分为保留组与对照组。比较2组术中情况与术后情况。结果术后2组均有患者出现感觉功能障碍。无论患者术中是否保留ICBN，术后在上臂内侧及腋窝发生疼痛及感觉功能障碍的情况都要远多于上臂前侧、外侧。上臂内侧和上臂外侧感觉障碍存在组间差异。保留组的上肢水肿发生率为5．41％，对照组则为27．27％，差异有统计学意义（χ2＝6．297，P＜0．05）。保留组的手术时间为（82．4±13．2）min，对照组则为（68．7±11．3），差异有统计学意义（t＝6．965，P＜0．05）。保留组皮肤感觉异常的发生率为5．41％，对照组则为48．48％，差异有统计学意义（χ2＝16．946，P＜0．01）。保留组针刺痛的发生率为2．70％，对照组则为27．27％，差异有统计学意义（χ2＝8．56，P＜0．01）。结论对乳腺癌患者予以乳腔镜腋窝淋巴结清扫术，并保留肋间臂神经可降低患者上肢水肿发生率、皮肤感觉异常的发生率及针刺痛，改善患者的生活质量。%Objective To investigate the clinical significance of intercostobrachial nerve preservation in mastoscopic ax-illary lymph node dissection for breast cancer.Methods 70 cases of breast cancer patients,based on whether to retain intercosto-brachial nerve,will be divided into the retain group and the control group.Intraoperative and postoperative situation were com-pared.Results Both groups had postoperative sensory dysfunction,regardless of whether underwent intercostobrachial nerve pres-ervation,their postoperative pain and sensory dysfunction cases in the upper arm and armpit were more than the inside of the front side and outside of the upper arm.The had significant differences between the 2 groups in sensory disturbances outside of the up-per arm and on the front side of the upper arm.The upper limb edema rate in the retain group was 5.41%, compared with 27.27%in the control group (χ2 =6.297,P<0.05).The operative time in the retain group was 82.4 ±13.2 min,and in the control group was 68.7 ±11.3 (t=6.965,P<0.05).Abnormal skin sensation rate in the retain group was 5.41%,and in the control group was 48.48%(χ2 =16.946,P<0.01).Acupuncture pain incidence in the retain group was 2.70%,and in the control group was 27.27%(χ2 =8.56,P<0.01).Conclusion Intercostobrachial nerve preservation in mastoscopic axillary lymph node dissection for breast cancer can reduce the upper limb edema rate,incidence of abnormal skin sensation rate,and im-prove the quality of life of patients.
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