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題 名 | 兩側頸部不完全肋骨:一病例報告=Bilateral Incomplete Cervical Ribs: A Case Report |
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作 者 | 高中錚; 尹居浩; 徐漢業; 方紹敏; 彭洪文; 陳毓堃; 譚傳明; 張永宗; 詹正雄; 閻中原; | 書刊名 | 醫學研究 |
卷 期 | 20:5 2000.04[民89.04] |
頁 次 | 頁257-261 |
分類號 | 416.26 |
關鍵詞 | 頸部肋骨; 胸部出口症候群; Incomplete cervical ribs; |
語 文 | 中文(Chinese) |
中文摘要 | 頸部肋骨可以壓迫上肢的神經與血管,是造成胸部出口徵候群的原因之一。一位二十三歲男性因左側鎖骨上凹摸到硬塊,有半牛之久,相關有手麻、運動無力等症狀,Roose試驗結果為陽性,左側三頭肌的深部神經反射減低,左側前臂有感覺異常(paresthesia)現象,左側骨間肌(interosseous)肌肉有輕微萎縮。胸部X光檢查發現兩側頸部第7頸椎不完全肋骨,且左側頸部肋骨較右側長。神經傳導檢查發現左側尺神經F潛時延長。肌電圖檢查發現左側外展姆短肌、第一指間肌、肱二頭肌及肱三頭肌,在靜止時有插入活動電位增加及在運動時出現多相波現象。Doppler血管超音波檢查發現兩側鎖骨下動脈正常,並無血管瘤發現。經半年休息後,左手神經學檢查均恢復正常,肌肉萎縮亦明顯改善。本病例以鎖骨上窩硬塊形式表,較為少見。由於目前頸部助骨是由頸椎轉形成胸椎,並與homeobox基因和癌症有關,因此這類病人宜長期追蹤。 |
英文摘要 | Cervical ribs is one of the causes of thoracic outlet syndrome by pressing nerves and blood vessels to upper limbs. We report a case of a 23-year-old man who was admitted to our hospital with left supraclavicular mass and arm weakness felling while exercise lasting for half year. Physical examination showed that a palpable mass was note in the left supraclavicular region. Roose test for left arm was positive. Deep tenden reflex of left tricep reduced, as well as hyperthesia in left front arm. Mild atrophy was found in left interosseous muscle. The motor nerve conductive velocity (NCV) was mildly prolonged for left median nerve. The sensory NCV was prolonged for left radial, median and ulnar nerves. Doppler sonography for bilateral subcavicular artery showed normal pattern. The X-ray film of neck showed incomplete bilateral genic thoracic outlet syndrome was diagnosed. After six months resting, the neurological test showed recovery of NCV, and the symptom was gradually getting lighter. Since cervical ribs were thought to be transformed from cervical vertebra, as well as closely related to homeobox gene and cancer, the patients should be long-time followed up. |
本系統中英文摘要資訊取自各篇刊載內容。