胸廓出口综合征35例误诊原因分析  

Cause Analysis of 35 Misdiagnosed Patients with Thoracic Outlet Syndrome

作　　者：武欣[1] 张海军 李学峰[1] 郭连瑞[1] 张建[1] 汪忠镐[1] 谷涌泉[1] 

机构地区：[1]首都医科大学宣武医院血管外科,首都医科大学血管外科研究所,北京100053 [2]宁城县医院血管外科,内蒙古宁城024200

出　　处：《临床误诊误治》2013年第8期25-27,共3页Clinical Misdiagnosis & Mistherapy

基　　金：863国家高技术研究发展计划(2012AA020507)

摘　　要：目的探讨胸廓出口综合征(thoracic outlet syndrome,TOS)的诊疗要点,提出防范误诊的措施。方法回顾性分析TOS 35例误诊的临床资料,分析其误诊的原因。结果本组临床表现均有颈肩痛或不适感,上肢乏力,手部麻木以环、小指为主,病程1.5～10年,平均4.5年。误诊为颈椎病15例,椎-基底动脉供血不足8例,肘管综合征、腕管综合征6例,肩周炎4例,脉管炎2例。所有患者经详细询问病史、仔细查体及相关医技检查确诊为TOS。35例均予保守治疗,症状均不同程度改善。结论提高临床医师对TOS的认识并准确查体是诊断TOS的关键。Objective To explore clinical manifestations of thoracic outlet syndrome（TOS） in order to prevent misdiagnosis.Methods Clinical data of 35 patients with thoracic outlet syndrome and misdiagnosis causes were retrospectively analyzed.Results Clinical manifestations in the group were cervicobrachialgia or discomfort,upper extremity acratia and hand numbness（mainly in ring and little fingers）,and course of disease was 1.5 ～10 years（average of 4.5 years）.Fifteen patients were misdiagnosed as having cervical osteoarthritis,8 as having vertebrobasilar ischemia,6 as having cubital tunnel syndrome or carpal tunnel syndrome,4 as having adhesive capsulitis,and 2 as having vasculitis.The TOS was confirmed in all patients by requiring history,physical check-ups and related medical examinations.All the 35 patients received expectant treatment,and symptoms improved to different degrees.Conclusion Improvement in clinicians＇ awareness and physical check-up are the key in diagnosis of TOS.

关 键 词：胸廓出口综合征 误诊 颈椎病 椎-基底动脉供血不足 

分 类 号：R655[医药卫生—外科学]