胸廓出口综合征手术方法改良

目的 在解剖学研究和临床分析的基础上提出了胸廓出口综合征手术方法的改良。方法 ３０例尸体解剖，研究前、中、小斜角肌的起止点和臂丛神经的关系。随访了术后６个月￣２年的１９例颈肩痛和手部麻木，肌肉萎缩的胸廓出口综合征患者，均做前，中斜角肌起点和小斜角肌切断术。

Modified Operation of Thoracic Outlet Syndrome

ObjectiveTo modify the operation method for thoracic outlet syndrome based on the anatomic dissection and clinical analysis. MethodsAnatomical study was done on both sides of 30 cadavers. The origin and insertion of anterior, middle and smallest scalene muscles, as well as their relations to brachial plexus were observed. Nineteen cases of thoracic outlet syndrome were treated by resection of anterior and middle scalene muscles at the origin, smallest scalene muscle was also cut. ResultsAnterior and middle scalene muscles originated from both anterior and posterior tubercle of cervical transverse process. C5 and C6 nerve roots might be pinched by the cross origin muscle fibers. Of 19 cases undergone resection of the anterior and middle scalene muscles at their origin, 18 had excellent results after 6 months to 2 years followup. ConclusionAnterior, middle and smallest scalene muscles are the main cause of thoracic outlet syndrome; anterior and middle scalene muscles should be resected from their origins, smallest scalene muscle should be cut as well.