上干型胸廓出口综合征的解剖与临床研究

Anatomical and clinical study of upper trunk thoracic outlet syndrome

目的 了解上干型胸廓出口综合征的解剖学依据 ,为临床诊治上干型胸廓出口综合征提供指导。 方法 解剖 30具成人固定尸体 ,作大体及显微解剖观察 ,了解臂丛神经上干与周围结构的关系 ;临床随访 7例上干型胸廓出口综合征手术疗效。 结果 前斜角肌在 C3～ 6 颈椎横突的前、后结节均有起点 ,中斜角肌起源于第 2～ 6或第 2～ 7颈椎横突的前、后结节。 C5 ,6 神经根出椎间孔后被中斜角肌和前斜角肌交叉的起点腱性纤维而包裹。 7例术后 5例疗效佳 ,1例复发局封后症状消失。 结论 前中斜角肌交叉起点是上干型胸廓出口综合征的主要病因。

Objective To describe the anatomic characteristics and the treatment of upper trunk thoracic outlet syndrome Methods Anatomic study was done on both sides of 30 embalmed cadavers, the anatomic relationship between upper trunk and the origins of the scalenus anterior and middle muscle were observed Seven cases of upper trunk thoracic outlet syndrome were treated and followed up Results Scalenus anterior and middle muscle originated from both anterior and posterior tubercle of C 2 to C 6 and C 2 to C 7 transverse process respectively Such bundles of muscle from anterior and posterior tubercle pinched the nerve roots of C 5～7 emerging immediately from intervertebral foramen Of the 7 cases that had undergone resection at the origin of scalenus anterior and middle muscle, 5 had excellent or good results Conclusion The contraction of the origin components of the scalenus anterior and middle muscle plays a important role in the production of upper trunk type of thoracic outlet syndrome, the scalenus muscles should be cut at the site of origin in patient with upper thoracic outlet syndorme