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[胸廓出口综合征:多学科诊断与治疗]

[Thoracic outlet syndrome : Interdisciplinary diagnostics and treatment].

作者信息

Ahrens Marc, Egberts Jan-H, Umstadt Julia, Bürger Thomas, Berndt Rouven, Debus E S, Preuß Mark

机构信息

Klinik für Allgemein- und Viszeralchirurgie, Bundeswehrkrankenhaus Hamburg, Hamburg, Deutschland.

Klinik und Poliklinik für Gefäßmedizin, Universitäres Herz- und Gefäßzentrum Hamburg, Martinistr. 52, 20246, Hamburg, Deutschland.

出版信息

Chirurgie (Heidelb). 2025 Sep 24. doi: 10.1007/s00104-025-02371-3.

Abstract

The thoracic outlet syndrome (TOS) refers to a group of clinical conditions caused by compression of nerves and blood vessels in congenital or acquired anatomical narrowing of the upper thoracic aperture. This includes the anatomical structures, such as the scalene muscles, the first rib, a possibly present cervical rib, the costoclavicular joint or the pectoralis minor muscle. Isolated venous compression is also known as thoracic inlet syndrome (TIS). The symptoms are diverse and the path to a correct diagnosis is often prolonged. In the absence of anatomical anomalies, conservative treatment is indicated, such as physical therapy and adequate pain management. Especially in young patients, TOS should be considered when embolic events in the upper extremities occur without other risk factors. Appropriate multimodal diagnostics and targeted therapy are challenging and require treatment in specialized departments. Surgical treatment is complex and over the years various procedures with a favorable outcome for the affected patients have been established.

摘要

胸廓出口综合征(TOS)是指一组由上胸廓入口先天性或后天性解剖狭窄导致神经和血管受压引起的临床病症。这包括一些解剖结构,如斜角肌、第一肋骨、可能存在的颈肋、肋锁关节或胸小肌。孤立性静脉受压也被称为胸廓入口综合征(TIS)。其症状多样,正确诊断的过程往往漫长。在没有解剖异常的情况下,建议采取保守治疗,如物理治疗和适当的疼痛管理。特别是在年轻患者中,当上肢发生栓塞事件且无其他危险因素时,应考虑胸廓出口综合征。适当的多模式诊断和靶向治疗具有挑战性,需要在专科科室进行治疗。手术治疗复杂,多年来已建立了各种对受影响患者有良好疗效的手术方法。

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