治疗胸廓出口综征不同手术入路的选择.pdf

摘 要 治疗胸廓出口综合征不同手术入路的选择 研究生:李平 导师:艾合买提江.玉素甫 教授 摘 要 目的：探讨经锁骨上前入路或经腋部正中入路治疗胸廓出口综合征的疗效比较。 方法：总结分析2000 年3 月～2008 年8 月胸廓出口综合征28 例，依据手术切口入 路分为经锁骨上前入路（A 组）和经腋部正中入路（B 组）。比较不同手术入路的 选择对术后疗效的影响。结果：术后随访6 个月至26 个月（平均随访时间为 18 个 月）发现，患侧肢体功能均有不同程度的改善，根据Roos 及Wood 的术后功能评价 标准评定：A 组：优4 例，良6 例，可1 例，差1 例，优良率75% 。B 组：优7 例， 良6 例，可2 例，差1 例，优良率81.3%，结果有统计学意义。结论：经腋部正中入 路和经锁骨上前入路手术治疗TOS，都达到治疗和改善TOS 症状的目的，取得良好 疗效。经锁骨上前入路较经腋部正中入路手术治疗TOS 疗效好，但有时手术难度大， 术后皮肤瘢痕位置在颈部影响美观。经锁骨上前入路手术治疗TOS 可能是临床发展 的趋势，而手术风险分析、术后疗效分析仍需进一步研究和探讨。 关键词：胸廓出口综合征；手术入路选择；疗效比较 —1— 新疆医科大学医学硕士学位论文 Choice of different surgical approach of thoracic outlet syndrome Postgraduate student: liping Tutor: Prof.ahmat yusufu Abstracts Objective: To study Surgical approach of thoracic outlet syndrome and its analysis of influencing factors. Methods: Aggregate analysis 28 cases from 2000, March to 2008, Auguest TOS patients, In accordance with the Surgical approach divided into four groups: Approached by the axillary approach (A), by the supraclavicular approach (B), compare different kind of surgical approach and its analysis of influencing factors. Results: All cases were followed up between 6 months to 26 months, the mean time being 18 months. Ipsilateral limb function in varying degrees to improve .According to postoperative functional evaluation criteria assess: A group: excellent 4 cases, good 6 cases, medium 1 cases, poor 1 cases, Excellent and good rate is 75.0%. B group: excellent 7 cases, good 6 cases, medium 2 cases, poor 1 cases, Excellent and good rate is 81.3%. Conclusion: By different kind of Surgical approach