颈肋综合征13例分析

目的探讨颈肋综合征的特点和治疗方法。方法回顾分析13例颈肋综合征的临床表现、手术探查所见和手术方法。本组臂丛下干受压型8例,臂丛中、下干受压型3例,全臂丛受压型2例。13例均有下颈部肿块,全部采用手术治疗。术中见不完整颈肋4例,完整颈肋7例,颈肋由两个节段组成2例;同时合并前、中、小斜角肌异常和纤维索带,共同构成对臂丛特别是下干的卡压。结果随访6个月～5年3个月,手术疗效优6例,良5例,可2例。结论颈肋综合征和颈肋两者内涵不同。颈肋可分为横突增长、不完整颈肋、完整颈肋和特殊形态等4种。而臂丛下干支配区的运动和感觉障碍以及下颈部肿块是颈肋综合征的重要特点,臂丛下干受压型是其主要临床类型。手术是主要的治疗措施,应将颈肋等卡压组织逐一切除或切断。建议将颈肋综合征作为胸廓出口综合征的特殊类型加以研究。

Analysis of 13 cases with cervical rib syndrome

Objective To investgate the clinical features and treatment methods of cervical rib syndrome.Methods The clinical manifestations, the surgical findings and managements of 13 patients with cervical rib syndrome were analyzed. All patients were divided into three groups by the compressed part of brachial plexus:inferior trunk compressed in 8 patients, both median and inferior trunks compressed in 3 and all three trunks compressed in 2. Lower cervical mass was existed in all 13 cases. All patiens were operated on, and incomplete cervical rib were found in 4 cases, complete cervical rib in 7, and the cerrical rib formed from two segments in 2. Furthurmore,anomalies were found in anterior,middle and small scalene muscle as well as fibrous band. These anormal factors together resulted in the compression to brachial plexus especially the inferior trunk.Results All of 13 patients were followed up from 6 months to 5 years plus 3 months. The excellent results were achieved in 6 cases, good in 5 and fair in 2 cases.Conclusion The meaning is different between cervical rib syndrome and cervical rib. There were 4 forms of the cervical rib: over-length of transverse process, incomplete cervical rib, complete cervical rib and other special shapes. The clinical features of cervical rib syndrome included motor and sensory disorders over the area distributed by the inferior trunck of brachial plexus, and lower cervical mass. The compression of the inferior trunck of brachial plexus is the main clinical type. Surgical management was the chief treatment. The compressed tissues such as cervical rib should be removed or cut off. It is suggested to take the cervical rib syndrome as a special form of the thoracic outlet syndrome for deeply research.