Gockel M
Rehabilitation Unit of the Orthopaedic Hospital of the Invalid Foundation, Finland.
Ann Chir Gynaecol. 1996;85(1):59-61.
The data from the nationwide hospital discharge register was used for collecting the diagnoses of the thoracic outlet syndrome (TOS) which were combined with the procedure numbers of first rib resection and scalenotomy. During the years 1987-1993 the total number of operative operative periods for patients with a TOS diagnosis was 483 for 464 patients. Each year first rib resections were done significantly (P = 0.001) more often (55.7 SE 7.1; 1.11/100,000) than scalenotomies (13.4 SE 1.8; 0.27/100,000). The operation for TOS was most commonly combined with the diagnosis of TOS with brachial plexus lesion in 53%, TOS NUD (not classified) in 21%, TOS with subclavian artery compression in 19%, with a cervical rib in 4% and TOS with venous compression in 3%. The large proportion of the diagnosis TOS NUD clearly shows the need for a better definition for the TOS diagnosis. As long as clear diagnostic criteria are lacking, the division of TOS into subgroups is arbitrary. Diagnostic division into true neurogenic, major arterial and venous TOS, and classifying the rest of the TOS diagnoses under TOS NUD or cervicobrachiale diffusum is recommended.
来自全国医院出院登记的数据用于收集胸廓出口综合征（TOS）的诊断信息，并与第一肋骨切除术和斜角肌切断术的手术编号相结合。在1987年至1993年期间，诊断为TOS的患者的手术总例数为464例，共483个手术周期。每年进行第一肋骨切除术的频率（55.7±7.1；1.11/100,000）明显高于斜角肌切断术（13.4±1.8；0.27/100,000）（P = 0.001）。TOS手术最常与以下诊断合并：伴有臂丛神经损伤的TOS，占53%；未分类的TOS（TOS NUD），占21%；伴有锁骨下动脉压迫的TOS，占19%；伴有颈肋的TOS，占4%；伴有静脉压迫的TOS，占3%。TOS NUD诊断的比例很高，这清楚地表明需要对TOS诊断进行更好的定义。只要缺乏明确的诊断标准，将TOS分为亚组就是随意的。建议将TOS诊断分为真正的神经源性、主要动脉性和静脉性TOS，并将其余的TOS诊断归类为TOS NUD或颈臂弥漫性病变。
