臂丛神经血管受压征13例手术治疗的随访

目的分析臂丛神经血管受压征(胸廓出口综合征)的手术疗效。方法对13例接受手术治疗的臂丛神经血管受压征患者进行随访,平均随访时间为3．2年。随访内容以患者的主观感觉为主,包括患肢麻木、酸痛、乏力、手部精细活动、发冷及肌肉萎缩等进行疗效的评价。结果术前13例均主诉有患肢感觉异常(麻木、刺痛觉减退),术后患肢感觉异常完全缓解或明显改善者12例(12／13),占92．4％;症状无变化或症状加重者1例(1／13),占7．6％。手部肌肉萎缩恢复者或改善者11例(11／12),占91．7％;手部肌肉萎缩无恢复或加重者1例(1／12),占8．3％。自觉患肢活动改善或症状完全缓解者11例(11／12),占91．7％;症状无变化或症状加重者1例(1／12),占8．3％。术前主诉有颈肩部酸痛者5例,术后症状明显改善或完全缓解者4例(4／5),占80％;症状无变化或症状加重者1例,占20％。结论采用手术治疗臂丛神经血管受压征是较有效的方法。

Treatment outcome of thoracic outlet syndrome: a follow-up of 13 patients

Objective To evaluate the outcomes of surgical treatment of thoracic outlet syndrome (TOS). Methods Thirteen patients of thoracic outlet syndrome who were operated from 2002 to 2004 were followed up. The average follow-up time was 3.2 years. Subjective parameters such as numbness, paraesthesia, pain, as well as weakness, fine movements of the hand and muscle atrophy were assessed. Results All 13 patients complained of paraesthesia (numbness and/or decreased pinprick spnsation) pre-operatively. This was resolved or improved in 12 patients (92.3%) . Those symptoms were not relieved or deteriorated in 1 patient (7. 6%). Intrinsic muscle atrophy was present pre-operatively in 12 patients and was better in 11 patients (91.7%) postoperatively.It was worse in 1 patient (8.3%).11 out of 12 (91.7%) patients who had impaired movement noticed improved movement after the surgery while one patient had no improvement. Five patients complained of neck and shoulder pain pre-operatively. The symptoms were resolved in 4 of those patients (80%). Conclusion Surgical decompression is an effective method for the treatment of TOS.