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胸廓出口综合征:一篇叙述性综述

Thoracic Outlet Syndrome: A Narrative Review.

作者信息

Li Nathan, Dierks Gregor, Vervaeke Hayley E, Jumonville Allison, Kaye Alan D, Myrcik Dariusz, Paladini Antonella, Varrassi Giustino, Viswanath Omar, Urits Ivan

机构信息

Medical College of Wisconsin-Milwaukee, Milwaukee, WI 53233, USA.

Louisiana State University Health Sciences Center-Shreveport, Shreveport, LA 71106, USA.

出版信息

J Clin Med. 2021 Mar 1;10(5):962. doi: 10.3390/jcm10050962.

Abstract

Thoracic outlet syndrome comprises a group of disorders that result in compression of the brachial plexus and subclavian vessels exiting the thoracic outlet. Symptoms include pain, paresthesia, pallor, and weakness depending upon the compromised structures. While consensus in diagnostic criteria has not yet been established, a thorough patient history, physical exam, and appropriate imaging studies are helpful in diagnosis. General first-line therapy for thoracic outlet syndrome is a conservative treatment, and may include physical therapy, lifestyle modifications, NSAIDs, and injection therapy of botulinum toxin A or steroids. Patients who have failed conservative therapy are considered for surgical decompression. This article aims to review the epidemiology, etiology, relevant anatomy, clinical presentations, diagnosis, and management of thoracic outlet syndrome.

摘要

胸廓出口综合征是一组导致臂丛神经和穿出胸廓出口的锁骨下血管受压的疾病。症状包括疼痛、感觉异常、苍白和无力,具体取决于受影响的结构。虽然诊断标准尚未达成共识,但详细的患者病史、体格检查和适当的影像学检查有助于诊断。胸廓出口综合征的一般一线治疗是保守治疗,可能包括物理治疗、生活方式调整、非甾体抗炎药以及肉毒杆菌毒素A或类固醇注射治疗。保守治疗失败的患者可考虑手术减压。本文旨在综述胸廓出口综合征的流行病学、病因、相关解剖、临床表现、诊断和治疗。

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Ann Vasc Surg. 2021 Jan;70:263-272. doi: 10.1016/j.avsg.2020.07.029. Epub 2020 Aug 6.
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Robotic-Assisted First Rib Resection: Our Experience and Review of the Literature.机器人辅助第一肋骨切除术:我们的经验和文献回顾。
Semin Thorac Cardiovasc Surg. 2020;32(4):1115-1120. doi: 10.1053/j.semtcvs.2020.04.016. Epub 2020 May 21.
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ACR Appropriateness Criteria® Thoracic Outlet Syndrome.美国放射学会适宜性标准®胸廓出口综合征
J Am Coll Radiol. 2020 May;17(5S):S323-S334. doi: 10.1016/j.jacr.2020.01.029.
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Thoracic outlet syndrome: a narrative review.胸廓出口综合征:一篇叙述性综述。
Rev Col Bras Cir. 2019 Dec 20;46(5):e20192243. doi: 10.1590/0100-6991e-20192243. eCollection 2019.

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