Sällström J, Thulesius O
Clin Physiol. 1982 Apr;2(2):117-25. doi: 10.1111/j.1475-097x.1982.tb00014.x.
Three hundred and seventy-seven patients with brachial pain and 63 controls have been examined regarding presence of symptomatic compression of the brachial plexus and subclavian vessels (Thoracic Outlet Syndrome = TOS). Each patient was examined clinically and by Doppler flowmetry. Two hundred and thirty (61%) had moderate to pronounced compression of the brachial plexus and 11 (2.9%) isolated compression of the subclavian artery or vein. One hundred and twenty-nine patients had symptoms not related to TOS. The prevalence of TOS was almost twice as common in women as in men, 1.76:1. The TOS patients were younger than the non-TOS patients, P less than 0.05. There was a significant correlation between arterial compression measured by Doppler flowmetry and the presence of compression of the plexus, P less than 0.001. But the validity of this method was not satisfactory, giving both false positive and negative results. Furthermore, there was a very good correlation between arterial compression assessed clinically and by Doppler flowmetry, P less than 0.001. Thus, the diagnosis of TOS is still a clinical judgement, the Doppler technique adding very little and any significant vascular compression being easily detected by clinical assessment.
对377例臂部疼痛患者和63例对照者进行了检查，以确定是否存在臂丛神经和锁骨下血管的症状性压迫（胸廓出口综合征=TOS）。对每位患者进行了临床检查和多普勒血流测定。230例（61%）有中度至明显的臂丛神经压迫，11例（2.9%）有锁骨下动脉或静脉单独压迫。129例患者的症状与TOS无关。TOS在女性中的患病率几乎是男性的两倍，为1.76:1。TOS患者比非TOS患者年轻，P<0.05。多普勒血流测定所测的动脉压迫与臂丛神经压迫的存在之间存在显著相关性，P<0.001。但该方法的有效性并不令人满意，会出现假阳性和假阴性结果。此外，临床评估和多普勒血流测定所评估的动脉压迫之间存在非常好的相关性，P<0.001。因此，TOS的诊断仍然是一种临床判断，多普勒技术作用不大，任何明显的血管压迫通过临床评估都很容易检测到。
