冷热觉测定在诊断胸廓出口综合征中的应用  

Diagnosis of lower trunk thoracic outlet syndrome by examination of the warm and cold sensation

作　　者：田东[1] 张凯丽[1] 

机构地区：[1]复旦大学附属华山医院手外科肌电图室,上海200040

出　　处：《中华手外科杂志》2006年第3期153-154,共2页Chinese Journal of Hand Surgery

基　　金：卫生部重大课题基金资助项目(2004-468-3)

摘　　要：目的探讨电生理冷热觉测定在诊断下干型胸廓出口综合征(thoracic outlet syndrome,TOS) 中的早期诊断价值。方法将50例(100侧)临床已确诊的单侧下干型TOS患者为TOS组,取年龄、性别相匹配健康成人50例(100侧)为对照组。应用冷热觉分别测定2组双侧前臂内侧肘下5cm处(前臂内侧皮神经所支配的皮肤感觉区)冷、热觉的阈值,并比较其差值。结果冷觉阈值TOS组:患侧为[(22．1± 3．0)℃,(x|-)±s,下同],健侧(27．7±2．5)℃;对照组双侧分别为(27．2±3．0)℃和(26．9±3．2)℃。热觉阈值 TOS组:患侧为(40．9±4．1)℃,健侧(35．8±3．0)℃;对照组双侧分别为(36．3±3．2)℃和(35．7±2．7)℃。患侧与2组健侧比较差异有统计学意义(P<0．05)。结论电生理冷热觉测定如健侧与患侧冷、热觉阈值相差≥4℃即为阳性,可作为早期下干型TOS的参考诊断指标之一。Objective To explore the early diagnostic value of the lower trunk thoracic outlet syndrome （TOS） by electrophysiological examination of the warm and cold sensation. Methods 50 patients with lower trunk TOS （100 sides） were studied and 50 health subjects （100 sides） matched as control group. The warm and cold sensation thresholds at 5 cm elbow to medial ante-brachial （dominated by medial ante-brachial cutaneous nerve） were electro- physiologically measured respectively, and the difference value was compared. Results In TOS group, the cold sensation threshold was （22.1 ±3.0）℃ in diseased side and （27.7 ± 2.5）℃ in healthy side respectively, the warm sensation threshold was （40.9 ± 4.1 ）℃ in diseased side and （35.8 ± 3.0）℃ in healthy side respectively, whereas in control group, the cold sensation threshold was （27.2 ± 3.0） ℃ in diseased side and （26.9 ± 3.2） ℃ in contralateral healthy side respectively and the warm sensation threshold was （36.3 ± 3.2） ℃ in diseased side and （35.7 ± 2.7） ℃ in healthy side respectively. There were significant differences in diseased side and contralateral healthy side （ P 〈 0. 05）. Coudusiou The difference values of the warm or cold sensation thresholds between diseased side and contralateral healthy side ≥4℃ can be used as one of the reference index in early diagnosis of the lower trunk thoracic outlet syndrome.

关 键 词：胸廓出口综合征 肌电描记术 诊断 前臂内侧皮神经 

分 类 号：R655[医药卫生—外科学]