中国胸廓出口综合征研究进展

Research progress in Thoracic outlet syndrome in China

胸廓出口综合征(TOS)指臂丛、锁骨下动脉、锁骨下静脉于胸廓出口区域受到卡压所引起的一系列临床症状综合征,根据受压结构分神经型、动脉型及静脉型。其中神经型比例高达90%,症状体征多变,缺乏敏感、特异的客观辅助检查,国际上至今无统一公认的诊断标准,一直是TOS研究的重点与难点。近数十年来国内学者对该疾病的关注持续提升,关于神经型胸廓出口综合征(NTOS)的中文文献报道逐年增多。本文旨在回顾总结中国学者在该领域的研究进展,同时结合国外文献的相关报道及作者诊疗团队的临床经验,对NTOS的诊断与治疗进行探讨。

Thoracic outlet syndrome(TOS)refers to a constellation of symptoms caused by a compression of brachial plexus,subclavian artery,and subclavian vein in the area of thoracic outlet.It is classified into neurogenic,arterial and venous TOS according to the structure of a compression.Neurogenic TOS(NTOS)shows various clinical symptoms and signs as well as lacks objective tests in adequate sensitivity or specificity constitutes approximately 90%of all TOS.To date,there is no consensus on diagnostic criteria around the world for TOS,and it has always been the focus point and challenge in TOS research.In last decades,Chinese surgeons paid increasing attentions to TOS,and it is evidenced by a great increase of numbers in Chinese literatures and reports.This article makes a brief review of the research progress reported in Chinese literature,and discusses the diagnosis and treatment of NTOS,based on the contributions made by Chinese researchers and relevant reports from abroad as well as the clinical experience from the author of this review article.