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在内窥镜辅助下手术治疗胸廓出口综合征10例报告

Surgical treatment of thoracic outlet syndrome assisted by endoscope: report of 10 cases

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【作者】 陈德松方有生蔡佩琴陈琳彭峰顾玉东

【Author】 CHEN De-song, FANG You-sheng, CAI Pei-qin, et al. Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai 200040, China

【机构】 复旦大学华山医院手外科复旦大学华山医院手外科 200040上海200040上海

【摘要】 目的 报告并探讨一个治疗胸廓出口综合征 (thoracicoutletsyndrome ,TOS)的新方法 ,即在内窥镜辅助下进行手术治疗。方法 局部麻醉下在颈外侧作 1.5cm长的小切口 ,在内窥镜的辅助观察下 ,切断部分前中斜角肌的腱性起始纤维。结果  2 0 0 2年 3月 11日至 2 0 0 2年 12月 16日 ,共作 10例。手术当天 10例的症状和体征均完全消失。术后随访 4个月~ 1年 ,平均 6个月。 5例的症状和体征完全消失。 4例的肌力恢复正常 ,前臂和小指的刺痛觉稍减退。 1例仅偶有颈部不适的症状 ,术侧锁骨区有麻痛 ,针刺有痛觉过敏。结论 在内窥镜辅助下经颈部微小切口切断部分前中斜角肌的腱性起始纤维 ,可解除斜角肌对臂丛神经的压迫 ,是一个创伤很小的治疗胸廓出口综合征的新方法。

【Abstract】 Objective To report and investigate a new treatment method of thoracic outlet syndrome (TOS.) assisted by endoscope. Methods After local anaesthesia, an incision 1.5 cm in length was made at the lateral neck. The tendon-like origin fiber of anterior and middle scalene muscles was cut partially under the endoscope. Results Ten cases of TOS were involved in the study from 11 March, 2002 to 16 December 2002. The symptoms and signs were disappeared completely immediately after operation. After 4 months to 1 year follow-up( mean: 6 months), the symptoms and signs were disappeared in 5 cases. The muscle power restored to normal, with prickling sensation decreased a little along the forearm and small finger in 4 cases. In 1 case occasional uncomfortable feeling occurred at the neck. There was numbness, pain and over-sensitivity to prickling around the clavicle in this patient. Conclusion Patial resection of the origin parts of anterior and middle scalene muscle with minor incision at the neck assisted by endoscope is a new way with minimal trauma for treatment of TOS, which can relieve the compression of the brachial plexus by the scalene muscles.

  • 【文献出处】 中华手外科杂志 ,Chinese Journal of Hand Surgery , 编辑部邮箱 ,2003年03期
  • 【分类号】R687
  • 【被引频次】9
  • 【下载频次】87
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