Colon E, Westdorp R
Department of Clinical Neurophysiology, St. Radboud University Hospital, Nijmegen, The Netherlands.
J Cardiovasc Surg (Torino). 1988 Mar-Apr;29(2):166-71.
Thoracic outlet syndromes are the result of vascular and/or nerve compression. In order to diagnose these syndromes careful clinical examination and objective testing are required. Vascular compression can be provoked by three well-defined thoracic outlet compression manoeuvres. Changes in vascular pulsation during these manoeuvres can be registered by means of plethysmography of the fingers. For an adequate interpretation of the clinical value of the various techniques of provoking vascular compression, a knowledge is required of the frequency with which vascular compression can be provoked in normal subjects of different age groups. We measured the changes in pulse in normal volunteers in 5-year age groups ranging from 15 to 85. This study showed that vascular compression until zero flow during 120 degrees arm abduction seems to be normal rather than abnormal. Zero flow during Adson manoeuvre and military attitude did not occur frequently in the supine position in normal subjects. Neither the different age groups nor the sexes showed any real differences in the quality of the findings. Therefore, establishing zero flow by means of a costoclavicular compression or scalenic compression is a clinically significant finding, while zero flow during 120 degrees abduction (pectoralis minor compression) is within normal limits.
胸廓出口综合征是血管和/或神经受压的结果。为了诊断这些综合征，需要进行仔细的临床检查和客观测试。血管受压可通过三种明确的胸廓出口压迫动作诱发。在这些动作过程中，手指体积描记法可记录血管搏动的变化。为了充分理解诱发血管受压的各种技术的临床价值，需要了解不同年龄组正常受试者中可诱发血管受压的频率。我们测量了15至85岁、每5岁为一组的正常志愿者的脉搏变化。这项研究表明，在120度手臂外展期间血管受压直至血流停止似乎是正常而非异常的。在正常受试者仰卧位时，Adson动作和军姿位时血流停止的情况并不常见。不同年龄组和性别在检查结果的性质上均未显示出任何实际差异。因此，通过肋锁压迫或斜角肌压迫导致血流停止是一项具有临床意义的发现，而在120度外展（胸小肌压迫）时血流停止则在正常范围内。
