切断小斜角肌后臂丛神经功能改变的临床观察  

The outcome of operative treatment by resection of scalenus minimus muscle in patients with thoracic outlet syndrome (TOS)

作　　者：尹望平[1] 陈德松[2] 方有生[2] 陈琳[2] 蔡佩琴[2] 

机构地区：[1]复旦大学金山医院骨科,上海200540 [2]复旦大学华山医院手外科

出　　处：《中国矫形外科杂志》2004年第11期828-832,共5页Orthopedic Journal of China

摘　　要：目的 :观测小斜角肌在TOS患者术中的出现情况 ,分析切断小斜角肌的临床意义。方法 :回顾性分析下干型TOS共 3 3例 ,手术中探查切断小斜角肌 ,其中 4例进行术中肌电的监测 ,比较术前、切断前中斜角肌后、切断小斜角肌后上臂近段尺神经MNCV ,前臂内侧皮神经SNAP和尺神经F反应的变化。结果 :术中探查 3 3例下干型TOS中均有小斜角肌的存在 ,术后优良率为 78 8%。切断前中斜角肌后、切断小斜角肌后 ,上臂近段MNCV ,前臂内侧皮神经SNAP和尺神经F反应均较术前有改善。结论 :小斜角肌在绝大多数下干型TOS患者中均有出现 ;切断小斜角肌后下干型TOS患者臂丛神经功能的改善较明显 ;Objective:To investigate clinical significance of the resection of scalenus minimus muscle on treatment of thoracic outlet syndrome.Method:A retrospective analysis of results of treatment were made in 33 cases of thoracic outlet syndrome (TOS).The resection of scalenus minimus muscle was made during the operation.And in 4 patients,motor never conduction velocity (MNCV) of ulnar nerve,sensory nerve action potential (SNAP) of medial antebrachial cutaneous nerve and F wave of ulnar were measured pre and post resection of scalenus minimus.Result:The scalene minimus muscle was found in 33 patients with TOS.According to the criteria by Roos and Wood,the excellent and good was 78.8%.Motor never conduction velocity (MNCV) of ulnar nerve,sensory nerve action potential (SNAP) of medial antebrachial cutaneous nerve and F wave of ulnar were improved after resection of scalenus minimus.Conclusion:Scalenus minimus muscle exits in most of patients with TOS,and the scalenus minimus muscle should be explored and resected during the operation.

关 键 词：胸廓出口综合征 肌 骨骼 解剖学 局部 小斜角肌 肌电扫描术 

分 类 号：R687[医药卫生—骨科学]