Dale W A, Lewis M R
Ann Surg. 1975 May;181(5):575-85. doi: 10.1097/00000658-197505000-00010.
This overall management program for thoracic outlet compression syndrome is based upon experience with 153 extremities in 149 patients and the results of others. The following conclusions are documented and discussed. 1) Diagnosis is based chiefly upon history; physical signs are inconstant and often absent. 2) Major vascular problems are unusual; angiography is not always necessary. 3) Electromyography is not always critical but does aid in diagnosis of carpal tunnel syndrome. 4) Non-operative treatment relieves most patients; operative decompression is indicated for a minority. 5) Transxillary first rib resection, with removal of cervical rib is the best operation. 6) Carpal tunnel decompression should be done concomitantly when needed. 7) Operation is relatively safe.
这个胸廓出口综合征的整体管理方案是基于对149例患者的153个肢体的经验以及其他研究结果制定的。以下结论得到了记录和讨论。1）诊断主要基于病史；体征不稳定且常不存在。2）主要血管问题不常见；血管造影并非总是必要的。3）肌电图并非总是关键的，但有助于诊断腕管综合征。4）非手术治疗可使大多数患者缓解；少数患者需要手术减压。5）经腋路第一肋切除术并切除颈肋是最佳手术方式。6）必要时应同时进行腕管减压术。7）手术相对安全。
