切断前中小斜角肌治疗胸廓出口综合征的疗效分析  

Surgical treatment of thoracic outlet syndrome by resection of scalenus muscles

作　　者：杨波[1] 单臣[1] 

机构地区：[1]吉林省人民医院手足显微外科,吉林长春130021

出　　处：《吉林医学》2009年第23期2927-2928,共2页Jilin Medical Journal

摘　　要：目的:探讨切断前中小斜角肌方法治疗胸廓出口综合征的疗效。方法:对26例27侧胸廓出口综合征患者行手术治疗,其中上干型3例,下干型21例22侧,全臂丛型2例,颈肋1例,第7颈椎横突过长1例,手术切除增长的骨组织和颈肋,发现均有纤维束带压迫臂丛神经,做前中小斜角肌切断术。结果:术后随访6～33个月,平均20个月,疗效按胸廓出口综幌征评定标准评定,术后症状明显改善18例19侧,部分改善5例5侧,无效3例3侧。结论:斜角肌的病变及异常纤维束带是引起臂丛神经血管受压的主要因素,早期手术探查,切断前中小斜角肌,彻底松解臂丛神经及血管。Objective To investigate the treatment of thoracic outlet syndrome by resection of the anterior, medium, and minimus scalenus muscles. Method Twenty - seven sides of twenty - six patients of thoracic outlet syndrome were surgically treated, with upper trunk type 3 cases ,lower trunk type 22 sides in 21 cases ,the whole brachial plexus type 2 cases. The prolonged transverse process of the seventh cervical vertebrae, cervical rib and scalenus muscles （including anterior, medium, and minimus scalenus muscles ） were resected. Results The follow - up for 6 - 33 months with the average of 20 months, remarkable alleviation of the symptoms and signs was reported in 19 sides of 18 cases, while partial improvement in 5 eases, symptoms and signs remained unchangeble in 3 cases. Conclusion Scalenus muscle is a main contributing factor of brachial plexus nervers and vessels compression syndrome ,transection of anterior, medium, and minimus scalenus muscles should be performed when surgical exploration is done.

关 键 词：胸廓出口综合征 臂丛 斜角肌 

分 类 号：R655[医药卫生—外科学] R687[医药卫生—临床医学]