摘要
目的:研究内窥镜治疗臂丛神经血管受压征的插入途径,开辟内窥镜在周围神经领域中的应用前景。方法:陈旧性尸体10具,新鲜尸体15具。距胸锁关节4cm处,于锁骨下1cm作皮肤横切口,将透明闭锁性外套管通过切口插入肋锁间隙,直达第1肋骨表面;再将30度斜视镜插入外套管中辨清周围组织结构后,用半月板切除刀沿肋骨表面切断前、中斜角肌止点。结果:术后切断锁骨充分暴露肋锁间隙段的臂丛神经血管,解剖验证内窥镜入路,未见损伤神经血管和胸膜顶。前、中斜角肌沿肋骨表面已被完全切断,并见明显回缩。结论:在内窥镜下于第1肋处可切断前、中斜角肌止点。操作安全、可靠,为临床应用提供了方法和步骤。
Objective: In order to verify the application of endoscope in peripheral nerve surgery,an anatomic study on the endoscopic approach in the treatment of thoracic outlet syndrome was performed. Methods: 10 fixed and 15 fresh cadavers were studied. A transverse incision 1cm below clavicle and 4cm from sternoclavicular articulation was used as the porta. A transparent and cleidoic lateral canula was inserted into the costoclavicular space to reach the first rib. A 30-degree-heteroscope was inserted in the lateral canula to observe the surrounding tissues. A meniscotome was then used to resect the insertions of scalenus anticus and medius muscle along the surface of the first rib. Results: After inspection of brachial plexus and the vessels in the costoclavicular space, it was confirmed that nerves, vessels, as well as cupula pleurae were intact. The sealenus anticus and medius muscle were reseeted completely and showed remarkable retraction. Conclusions: The insertions of scalenus anticus and medius muscle can be resected safely along the surface of the first rib by endoscope. The study provides detailed manipulation of the procedure for clinical application.
出处
《中华手外科杂志》
CSCD
1997年第3期178-180,共3页
Chinese Journal of Hand Surgery
基金
国家博士后基金
关键词
内窥镜
臂丛神经
血管受压
胸廓出口综合征
Endoscopy Brachial plexus Peripheral nerves BIood vessels Thoracic outlet syndrome
