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目的研究臂丛上干被斜角肌卡压后的临床特点及其内科治疗效果。方法回顾分析27例臂丛上干压迫症患者的临床资料。结果患者均表现为一侧上肢桡侧感觉障碍,部分患者合并同侧肩背部或胸部感觉异常;所有患者病侧的胸锁乳突肌后缘中点或中下1/3处均有明显压痛,并放散到患侧上肢、肩背或胸部感觉病变受累区域;55.6%(15/27)患者,当患肢处于外展外旋位时,诱发疼痛加重。25.9%(7/27)患者神经传导速度轻度减低,7.4%(2/27)患者大鱼际运动单位电位异常。影像学未见相关责任病灶。局部封闭并理疗4周后显效和有效分别为33.3%(9/27)和51.9%(14/27),无效14.8%(4/27)。结论胸锁乳突肌后缘中点或中下1/3交点压痛并向患侧上肢感觉受累区放散是斜角肌卡压臂丛上干神经的特征;压痛点局部封闭并理疗是有效的内科治疗方法。
Objective To study the clinical features of brachial plexus after being entrapped by the scalene muscle and its medical treatment effect. Methods The clinical data of 27 patients with brachial plexus compression syndrome were retrospectively analyzed. Results All patients showed side-sided sensory dysfunction of the radial side, and some patients had sensory abnormality on the ipsilateral shoulder or chest. All patients had obvious tenderness at the midpoint of the posterior border of the sternocleidomastoid muscle or 1/3 , And diffused to the diseased affected area of upper limbs, shoulders or thorax. In 55.6% (15/27) patients, the pain was aggravated when the limb was in the outreach external rotation. Nerve conduction velocity was slightly decreased in 25.9% (7/27) patients, and abnormal motor potential in large intertidal segments in 7.4% (2/27) patients. Imaging studies have not seen the responsibility of the lesion. After partial closure and physical therapy for 4 weeks, the effective and effective were 33.3% (9/27) and 51.9% (14/27), respectively, and 14.8% (4/27) ineffective. Conclusion The sternocleidomastoid muscle posterior border midpoint or lower third of the intersection of tenderness and the affected side of the upper extremity sensory involvement area is characterized by mitten muscle compression brachial plexus of the upper trunk nerve; tenderness point local closed and physical therapy is effective Medical treatment.