【摘要】 目的　讨论肩胛上神经卡压的诊断和治疗。方法　对近 6年来收治的 2 4例肩胛上神经卡压的病史进行分析 ,发现患者在肩外展起始 30°时 ,冈上、下肌肌力明显下降 ;同时双上肢在伸直位、肩关节前屈 90°位 ,交叉于胸前时可诱发肩胛部疼痛 ;此两点为肩胛上神经卡压的特殊体征。肌电图检查显示肩胛上神经慢性损伤。 2 1例于肩胛切迹处痛点作局部封闭治疗。 3例手术治疗 ,切断肩胛横韧带。结果　保守疗法中 7例失访 ,14例获 6个月以上的随访 ,有效率达 5 7.14 % ,其中 3例因无效后期改行手术治疗。手术治疗 6例 ,术后随访 6个月以上 ,症状完全消失 ,但肌萎缩均无明显改善 ,未发现有复发者。结论　颈肩痛患者系肩胛上神经卡压引起并不罕见 ,一旦确诊 ,可先于肩胛切迹处压痛点处作封闭治疗 ;如无显著效果 ,或出现明显肌萎缩者 ,应采取手术治疗。更多还原

【Abstract】 Objective To discuss the diagnosis and treatment of suprascapular nerve compression syndrome. Methods 24 cases of suprascapular nerve compression syndrome treated in the last 6 years were reviewed. Physical examination of the patients revealed that muscle power of supraspinatus and infraspinatus muscles decreased remarkably when the shoulder was abducted to 30°. Pain was induced around the scapular when the two upper limbs were crossed before the chest with shoulder at 90° of anterior flexion and elbow extended. These were characteristic signs of suprascapular nerve compression syndrome. EMG showed chronic neuropathy of suprascapular nerve. Local blockage to the point of tenderness at scapular notch was done in 21 cases. 3 cases were treated by surgical intervention to cut the transverse scapular ligament. Results 14 cases of conservative treatment were followed for more than 6 months. The effective rate was 57.14 %. 3 cases resorted to surgical treatment because the conservative treatment failed. All 6 surgically treated cases were followed for more than 6 months. The symptoms disappeared without recurrence. Muscle atrophy didn’t recover. Conclusions Suprascapular nerve compression is not a rare cause for neck shoulder pain. Once the diagnosis is made, local blockage at the scapular notch is recommended. Operation is indicated in case conservative treatment doesn’t work or there is obvious muscle atrophy.更多还原