胸廓出口综合征合并上臂桡神经卡压的诊治

目的探讨胸廓出口综合征合并上臂桡神经卡压的诊断和治疗方法.方法2002年1月-2005年1月我科共收治16例胸廓出口综合征合并上臂桡神经卡压患者,16例均先作颈部及上臂麻痛点封闭.7例因症状反复发作而改作手术治疗,其中4例单纯松解了锁骨上臂丛神经,3例臂丛神经和上臂段桡神经均作了松解.结果随访6个月～3年,按成效敏等的评定标准:优7例,良8例,差1例.结论胸廓出口综合征合并上臂桡神经卡压客观存在,此类患者可先保守治疗,以颈部和上臂压痛点局封为主,若效果不佳行手术治疗,可先松解臂丛神经,再松解上臂桡神经.

Diagnosis and Treatment of the Compression of Both Brachial Plexus and Radial Nerve in Upper Arm

Purpose To discuss the diagnosis and treatment of the compression of both brachial plexus and radial nerve in upper arm. Methods Sixteen patients with compression of both brachial plexus and radial nerve in upper arm found from January 2002 to January 2005 were treated in our department. Local blockage to the point of tenderness at neck and up arm was done in all the 16 cases.Because of persisted symptoms 7 patients were operated,4 cases released of brachial plexus simply,3 cases released not only brachial plexus but also radial nerve in upper arm. Results Follow up was 6 months to 3 years.According to assessment standard described by Chen, treatment outcome was excellent in 7 case, good in 8 case, poor in 1 case. Conclusions Brachial plexus and radial nerve in upper arm can be both compressed at the same time. Once the diagnosis is made,local blockage at the neck and up arm is recommended.Operation is indicated in case conservative treatment do not work,and brachial plexus can be released first.