内镜辅助下手术治疗上干型胸廓出口综合征的临床应用

Treatment of upper plexus thoracic outlet syndrome by endoscope assisted operation

目的报告内镜辅助下手术治疗上干型胸廓出口综合征的方法及临床疗效。方法16例上干型胸廓出口综合征患者局麻下通过颈外侧区作长1.5cm切口,在内镜辅助下切断部分前、中斜角肌的腱性起始纤维。结果术后平均随访25个月(16￣36个月),按WOOD等的评定标准评价:优9例,良5例,可2例。结论在内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,是一种治疗上干型胸廓出口综合征的有效微创手术方法。

[Objective] To report a new treatment method of upper plexus thoracic outlet syndrome assisted by endoseope. [Methods] 16 patients suffered from upper plexus thoraeie outlet syndrome were operated in this way： after loeal bloek, an incision 1.5 cm in length was made at the lateral neck, the tendon-like origin fiber of anterior and middle scalene museles were cut partially under the endoscope. [Results] Follow-up was 16 months to 3 years （average 25 months）. According to assessment standard described by wood, treatment outcome was excellent in 9 case, good in 5 case, general in 5 case. [Conclusion] Partial resection of the origin parts of anterior and middle scalene muscle with minor incision at the neek assisted by endoscope is a new way with minimal trauma for treatment of upper plexus thoracic outlet syndrome which can relieve the compression of the brachial plexus by the sealene muscles.