Maisonneuve H, Planchon B, de Faucal P, Mussini J M, Patra P
Service de Médecine Interne, Hôtel Dieu, CHU Nantes.
J Mal Vasc. 1991;16(3):220-5.
On the basis of a prospective study of 104 patients, the authors discuss the diagnostic value of the clinical symptoms revealing the thoracic outlet syndrome (TOS), as well as the specificity of the vascular functional exploration carried out to establish the diagnosis. Non-systematized pain and dysesthesia in the upper limb, with a postural or nocturnal onset, and Raynaud's sign are the most frequently observed signs. The "candlestick" maneuver still is the most reliable clinical triggering maneuver. The clinical features and the vascular functional explorations (capillaroscopy and digital plethysmography) allow demonstrating the existence of a true Raynaud's syndrome secondary to the TOS. The results of the arterial Doppler study distinguish the symptomatic and asymptomatic sides in the same patient, though without any correlation with the symptoms observed. The Doppler examination therefore seems to be reliable to demonstrate an anatomical duct, but remains insufficient to establish a causal relationship with the signal symptoms in most cases.
基于对104例患者的前瞻性研究,作者探讨了揭示胸廓出口综合征(TOS)的临床症状的诊断价值,以及为确立诊断而进行的血管功能检查的特异性。上肢出现无规律的疼痛和感觉异常,呈姿势性或夜间发作,以及雷诺氏征是最常观察到的体征。“烛台”手法仍是最可靠的临床激发手法。临床特征和血管功能检查(毛细血管镜检查和指容积描记法)能够证实继发于TOS的真性雷诺氏综合征的存在。动脉多普勒研究结果可区分同一患者的患侧和无症状侧,尽管与观察到的症状无任何相关性。因此,多普勒检查似乎可可靠地显示解剖管道,但在大多数情况下仍不足以确立与体征症状的因果关系。