10例上干型胸廓出口综合征诊治回顾性分析

Diagnosis and trealment of upper trunk type thoracic outlet syndrome： retrospective analysis of 10 cases

目的通过对10例上干型胸廓出口综合征（thoracic outlet syndrome，IDs）患者的诊治进行回顾性分析，探讨前中斜角肌起点切断治疗的疗效。方法对10例明确诊断为上干型胸廓出口综合征患者在全身麻醉下行前中斜角肌起点切断，记录手术前后症状、体征和肌电图以及必要的辅助检查进行疗效分析，并与颈5、6椎间盘突出征病例进行鉴别诊断。结果术后10例随访5—7年，平均6．2年。按顾玉东提出的臂丛神经上干功能评定标准评价：优5例，良3例，可2例。结论明确上干型胸廓出口综合征的诊断标准，前中斜角肌起点切断效果满意。与颈5、6椎间盘突出征鉴别诊断明确。

Objective To evaluate the curative effect of resection of the origins of anterior and middle scalenus muscles in the surgical treatment of upper trunk type thoracic outlet syndrome. Methods A retrospective review of 10 cases of upper trunk type thoracic outlet syndrome was carried out. These patients underwent surgical treatment under general anesthesia to resect the origins of the anterior and middle scalenus muscles. Pre- and post-operative symptoms, signs, EMG and necessary auxiliary examinations were analyzed. Differential diagnosis with C5,6 intervertebral disk hernia was made. Results The postoperative follow-up period ranged from 5 to 7 years, with an average of 6.2 years. According to the assessment criteria proposed by GU Yu-dong, the results were excellent in 5 eases, good in 3 eases and poor in 2 eases. Conclusion When the diagnostic criteria of upper trunk type thoracic outlet syndrome are defined, resection of the origins of anterior and middle scalenus muscles leads to satisfactory outcomes. The differential diagnosis with C5,6 intervertebral disk hernia is clear.