锁骨上斜角肌切除术治疗胸廓出口综合征——使用DASH评分系统评估功能结果
Supraclavicular scalenectomy for thoracic outlet syndrome--functional outcomes assessed using the DASH scoring system.
作者信息
Glynn Ronan W, Tawfick Wael, Elsafty Zahrah, Hynes Niamh, Sultan Sherif
机构信息
Department of Vascular and Endovascular Surgery, Western Vascular Institute, Galway University Hospital, Galway, Ireland.
出版信息
Vasc Endovascular Surg. 2012 Feb;46(2):157-62. doi: 10.1177/1538574411434164. Epub 2012 Feb 5.
INTRODUCTION
To evaluate supraclavicular scalenectomy ± cervical rib excision for thoracic outlet syndrome (TOS), employing Disability of Arm, Shoulder, and Hand (DASH) scoring for functional assessment post-decompression.
METHODS
A QuickDASH score was calculated for each patient using the algorithm: ([sum of responses/n] - 1) × 25, where n = number of completed responses. Nonparametric analysis was employed, with significance defined as P ≤ .05.
RESULTS
Twenty-one patients were treated for TOS by the same surgeon; with 5 bilateral procedures (total = 26 procedures). Median DASH scores pre- and postoperatively were 68.5 and 36.0, respectively (P = .002). Just one reported worsening of symptoms postoperatively. Antecedent trauma and smoking were inversely associated with DASH score postoperatively (P = .005 and P = .005). Postoperative scores were less for patients with vascular symptoms (P = .011); scores did not change significantly for those with neurologic (P = .066) or mixed symptoms (P = .345).
CONCLUSIONS
This study reconfirmed the value of supraclavicular approach for TOS, with the vast majority reporting subjective improvement.
引言
为评估锁骨上斜角肌切除术±颈肋切除术治疗胸廓出口综合征（TOS）的效果，采用上肢、肩部和手部功能障碍（DASH）评分对减压术后功能进行评估。
方法
使用以下算法为每位患者计算快速DASH评分：（[回答总和/回答数量] - 1）×25，其中n = 完整回答的数量。采用非参数分析，显著性定义为P≤0.05。
结果
同一位外科医生对21例患者进行了TOS治疗；其中5例为双侧手术（共26例手术）。术前和术后的DASH评分中位数分别为68.5和36.0（P = 0.002）。只有1例报告术后症状恶化。既往创伤和吸烟与术后DASH评分呈负相关（P = 0.005和P = 0.005）。有血管症状的患者术后评分较低（P = 0.011）；有神经症状（P = 0.066）或混合症状（P = 0.345）的患者评分无显著变化。
结论
本研究再次证实了锁骨上入路治疗TOS的价值，绝大多数患者报告主观症状改善。
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