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胸廓出口综合征长期功能康复的预测因素:85例患者

[Predictive factors of long-term functional rehabilitation in thoracic outlet syndromes: 85 patients].

作者信息

Ghoussoub K, Tabet G, Faraj C, Sleilaty G, Roukoz S, Jebara V

机构信息

Service de médecine physique et réadaptation, CHU Hôtel-Dieu de France, Beyrouth, Liban.

出版信息

Ann Readapt Med Phys. 2007 Apr;50(3):134-9. doi: 10.1016/j.annrmp.2006.12.006. Epub 2006 Dec 22.

Abstract

INTRODUCTION

Thoracic outlet syndromes are expressed by various clinical manifestations. Treatment is mainly rehabilitation. We aimed to identify factors predicting long-term functional rehabilitation in patients with this treatment and recurrence of symptoms.

PATIENTS AND METHODS

We performed a descriptive retrospective analysis of 84 patients who underwent rehabilitation for thoracic outlet syndrome as defined by Revel and colleagues. Data collection involved a questionnaire exploring personal information, risk factors for developing thoracic outlet syndrome, clinical signs, and x-ray results. Long-term results of treatment were evaluated by telephone questionnaire. Data analysis involved use of Stata 6 software.

RESULTS

Univariate analysis: predictive factors of negative results with treatment were ligament hypermobility, sensitive disturbances at the time of diagnosis, and a positive Adson's test result. Predictive factors of positive results were absence of paresthesia at the end of the treatment, and a negative "bell sign" at the end of the treatment. Predictive factors of nonrecurring symptoms were age younger than 34, bilateral positive Adson test result, and need for a supplementary number of sessions. MULTIVARIATE ANALYSIS: predictive factors of positive results with treatment were absence of sensitive impairment at the time of diagnosis, compliance with home exercises, initial negative Adson's test result, absence of hypermobility, and absence of paresthesia at the end of treatment. Predictive factors of recurring symptoms were age younger than 34, the need for a supplementary number of sessions and bilateral positive Adson's test result.

CONCLUSION

A larger number of subjects are needed to further explore the predictive factors of rehabilitation and recurring symptoms in thoracic outlet syndrome for better validity and significance.

摘要

引言

胸廓出口综合征有多种临床表现。治疗主要是康复治疗。我们旨在确定预测该治疗患者长期功能康复及症状复发的因素。

患者与方法

我们对84例按照雷维尔及其同事所定义的胸廓出口综合征接受康复治疗的患者进行了描述性回顾性分析。数据收集包括一份探索个人信息、胸廓出口综合征发病危险因素、临床体征及X线结果的问卷。通过电话问卷评估治疗的长期结果。数据分析使用Stata 6软件。

结果

单因素分析:治疗结果为阴性的预测因素是韧带过度活动、诊断时感觉障碍及阿德森试验结果阳性。治疗结果为阳性的预测因素是治疗结束时无感觉异常及治疗结束时“钟摆征”阴性。症状未复发的预测因素是年龄小于34岁、双侧阿德森试验结果阳性及需要额外疗程数。多因素分析:治疗结果为阳性的预测因素是诊断时无感觉损害、坚持家庭锻炼、初始阿德森试验结果阴性、无过度活动及治疗结束时无感觉异常。症状复发的预测因素是年龄小于34岁、需要额外疗程数及双侧阿德森试验结果阳性。

结论

需要更多受试者进一步探索胸廓出口综合征康复及症状复发的预测因素,以提高有效性和意义。

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