胸廓出口综合征的外科治疗  

Microsurgical treatment for patients with thoracic outlet syndrome

作　　者：姚倍金[1] 林浩[1] 冉忠营 韩国强[1] 刘窗溪[1] 

机构地区：[1]贵州省人民医院神经外科,贵阳550002

出　　处：《中华神经外科杂志》2014年第4期384-386,共3页Chinese Journal of Neurosurgery

摘　　要：目的探讨胸廓出口综合征显微外科治疗的临床疗效。方法对2012年1月至2013年3月收治的7例胸廓出口综合征进行分析，其中上干型1例，下干型5例，血管型1例。X线示C7横突过长2例，颈肋1例，未见骨性异常4例。采用前中小斜角肌切断术7例，臂丛神经外膜松解术3例。结果术后随访6—14个月，平均9．5个月。症状完全消失、能胜任原来工作、日常生活恢复正常4例；残留部分症状，但不影响原来工作2例；症状部分缓解1例。结论显微镜下斜角肌切断及臂丛神经外膜松解术治疗胸廓出口综合征，能更充分保护臂丛神经及其供血血管，术后临床效果良好。Objective To investigate the therapeutic efficacy of microsurgical treatment for thoracic outlet syndrome（TOS）. Methods Microsurgical procedures were performed in seven patients with TOS from January 2012 to March 2013. There were upper trunk TOS in 1 case, lower trunk in 5 and vascular type TOS in 1. The findings of X - ray showed prolonged transverse process of 7th cervical vertebrae in 2 cases and cervical rib in 1. The resection of cervical rib and scalene muscles （ including anterior, middle and minimal scalene muscles） were performed in 7 cases and neurolysis of brachial plexus in 3. Results The follow - up for 6 - 14 months （ mean 9. 5 months） suggested the excellent improvement of symptoms in 4 cases, part of syndrome residual in 2 and mild remission in 1. Conclusions Microsurgical decompression and neurolysis of brachial plexus was an effective method for patients with TOS.

关 键 词：胸廓出口综合征 斜角肌切断术 臂丛神经外膜松解 显微外科手术 

分 类 号：R655[医药卫生—外科学]