经腋路内窥镜辅助下切除第一肋骨治疗胸廓出口综合征  

Endoscope assisted transaxillary first rib resection for the treatment of thoracic outlet syndrome

作　　者：徐杰[1] 吴世强[2] 林院[1] 罗奋棋[1] 

机构地区：[1]福建省立医院骨二科,福州350001 [2]福建医科大学省立临床学院骨二科

出　　处：《中华手外科杂志》2008年第6期366-368,共3页Chinese Journal of Hand Surgery

基　　金：福建省科技厅青年人才基金资助项目（2004J071）;福建省自然科学基金资助项目（2006J0327）

摘　　要：目的报告内窥镜辅助下手术治疗下干型胸廓出口综合征的方法及临床疗效。方法采用内窥镜辅助下经腋路第一肋骨切除术治疗下干型胸廓出口综合征14例。结果术后随访时间为12—24个月，14例患者症状完全解除，未见复发。4例第一骨间背侧肌萎缩者，有2例完全恢复，2例部分恢复。按照Wood等提出的评价标准评定：优11例（占78．6％），良3例（占21．4％）。结论经腋路内窥镜辅助下切除第一肋骨治疗下干型胸廓出口综合征，手术创伤小，伤口隐蔽，减压彻底，疗效满意。Objective To report a method and clinical effect of endoscope assisted surgery for treatment of lower trunk type thoracic outlet syndrome. Methods fourteen cases of lower plexus type thoracic outlet syndrome were treated with transaxillary first rib resection assisted by endoscope. Results All the eases were followed for 12 to 24 months postoperatively. Symptoms were relieved in all of the 14 eases and there was no one recurrence. For the 4 eases with muscle atrophy of the first dorsal interoseous muscle, complete restoration was achieved in 2 eases and partial restoration in 2 cases. According to Wood＇ s evaluation criteria, the results were rated as excellent in 11 eases （78.6%） and good in 3 cases （21.4%）. Conclusion Endoscope assisted transaxillary first rib resection is an optimal procedure for the treatment of thoracic outlet syndrome. It is minimally invasive with a small and concealed incision. It achieves complete decompression, which leads to low recurrent rate and satisfactory results.

关 键 词：胸廓出口综合征 臂丛 内窥镜 第一肋骨切除术 

分 类 号：R686[医药卫生—骨科学]