摘要
目的:探讨颈肋综合征的局部病理改变及对相应支配区运动、感觉及血管功能的影响。方法:回顾分析1990-01/2003-12南京大学医学院附属鼓楼医院骨科手术治疗的颈肋综合征11例患者的临床表现,与X射线片表现、手术探查所见和手术方法,并根据Roos的标准对手术疗效进行优、良、可、差4级评定。结果:术中探查见颈肋、前斜角肌、中斜角肌均有病理改变。在1例全臂丛受压型,颈5,6神经根前后紧贴前、中斜角肌,并有纤维索带从其表面横跨。手术疗效优4例,良5例,可2例。结论:臂丛下干支配区的运动和感觉障碍是颈肋综合征主要和早期的特征表现。颈肋可分为横突增长、不完整颈肋、完整颈肋和其他形态等4种。临床发现颈肋综合征的局部病理改变包括颈肋、斜角肌的异常和对臂丛神经的卡压。需要和尺神经卡压症相鉴别。手术是主要的治疗方法。
AIM:To probe into the effect of local pathological changes of cervical rib syndrome on the functions of motion,aesthesia and blood vessels in corresponding regions dominated by cervical rib. METHODS:The clinical manifestations,the features of X-ray films,the surgical findings and managements of 11 patients with cervical rib syndrome operated in the Department of Orthopaedics,Drum Tower Hospital Affiliated to Nanjing University Medical School from January 1990 to December 2003 were reviewed and analyzed.The postoperative effects were assessed in terms of excellent,good,fair and poor grades according to Roos' criterion. RESULTS:Pathological changes were found in cervical,anterior scalene muscle and middle scalene muscle.Brachial plexus compression was found in one case,whose anterior or posterior fifth and sixth(C5-6) cervical nerve roots adhered to the anterior and middle scalene muscles closely with the fibrous band crossing their surface.The excellent results were achieved in 4 cases,good in 5 cases and fair in 2 cases postoperatively. CONCLUSION:The motion dysfunction and paresthesia over the area distributed by the inferior trunk of brachial plexus were the main and early clinical manifestation.There were 4 forms of the cervical rib:over-length of C7 transverse process,incomplete cervical rib,complete cervical rib and other special shapes.The clinical local pathological findings of cervical rib syndrome were the cervical rib,abnormal scalenus and their compression on the brachial plexus.It is necessary to differentiate the syndrome from the ulnar nerve entrapment.Surgical management was the chief treatment.
出处
《中国临床康复》
CSCD
2004年第35期7978-7979,i003,共3页
Chinese Journal of Clinical Rehabilitation
