[1]谷奇,刘雪来,李龙,等.内镜下胸锁乳突肌切断治疗肌性斜颈的疗效观察[J].中国微创外科杂志,2006,06(9):686-687.
　Gu Qi,Liu Xuelai,Li Long,et al.Endoscopic sternocleidomastoid muscle amputation for the treatment of congenitalmuscular torticollis[J].Chinese Journal of Minimally Invasive Surgery,2006,06(9):686-687.
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内镜下胸锁乳突肌切断治疗肌性斜颈的疗效观察()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
06
期数:
2006年9期
页码:
686-687
栏目:
出版日期:
2006-09-20

文章信息/Info

Title:
Endoscopic sternocleidomastoid muscle amputation for the treatment of congenitalmuscular torticollis
作者:
谷奇; 刘雪来; 李龙; 张军; 刘钢①; 黄柳明①　
首都儿科研究所小儿外科,北京,100020
Author(s):
Gu Qi;  Liu Xuelai;  Li Long;  et al.
Department of Pediatric Surgery, Capital Institute of Pediatrics, Beijing 100020, China
关键词:
内镜; 斜颈; 胸锁乳突肌
Keywords:
Endoscope; 　Torticollis; 　Sternocleidomastoidmuscle
分类号:
R685;R682.2+4
文献标志码:
A
摘要:
目的 探讨内镜下离断胸锁乳突肌治疗肌性斜颈的效果.方法 23例肌性斜颈患儿,年龄1个月～12岁,中位数2岁6个月.右侧腋窝皮纹线内置入5 mm trocar,手持镜头将胸锁乳突肌下端胸骨头和锁骨头表面的肌膜钝性分离,充入CO2气体加压至6 mm Hg,形成皮下空间.在外侧颈下横纹内和前胸横纹处切开3 mm分别置入3 mm弯钳和电刀尖.电凝或电切横断胸锁乳突肌纤维束,松解胸锁乳突肌周围的纤维组织.结果 23例均在内镜下完成手术.平均手术时间51.2 min(35～135 min),术中出血量均＜1 ml.无损伤周围大血管和神经.1例颈部切口处皮肤轻微电灼伤,2周后自愈.术后行颈部舒展活动训练,术后第1天出院.23例随访3个月～4年,中位时间6个月,斜颈均矫正,疗效优18例,良5例,切口瘢痕不明显,皮肤弹性好,随表情无异常活动现象,无复发.结论 内镜下胸锁乳突肌切断治疗肌性斜颈具有微创、恢复快、效果好的优点,瘢痕不明显,美观且不损伤颈阔肌,对表情活动无影响.
Abstract:
Objective　To investigate curative effects ofendoscopic sternocleidomastoidmuscle amputation for the treatmentof congenitalmuscular torticollis.　M ethods　A total of23 childrenwith congenitalmuscular torticolliswere treated in this department. Their agewas 1 month ~ 12 years old (median, 30 months).A 5 mm trocarwas inserted through the right axilla along the cleavage lines. Under the endoscopic visualization, the sarcolemma on the inferior portion of the muscle was bluntly dissected and a subcutaneous spacewas established by CO2inflation at the pressure of 6 mm Hg. Another two 3 mm incisions were made along the cleavage lines at lower lateral part of the neck and the anterior chestwall for the introduction of curved forceps and electric knife, respectively. The sternocleidomastoid muscle was transected with electrocautery and the external fascia within which the sternocleidomastoid muscle resides was also adequately divided.　Results　The operation was successfully completed under endoscope in all the 23 children. Themean operation timewas 51. 2 min (range, 35~135 min) and the intraoperative blood losswas < 1 m.l No injuries ofmajor blood vessels or nerveswere encountered. Slight electric burn was noted in 1 child and healed up after twoweeks. All the children were instructed for cervical exercises and were discharged from hospital on the first day postoperatively. Follow-up checkups for3 months ~ 4 years (median, 6 months) in all the patients showed satisfactory cosmetic appearance and no recurrence. The curative effectswere classified as“excellent”in 18 children and“good”in 5 children.　Conclusions　Endoscopic sternocleidomastoidmuscle amputation fr the treatment ofmuscular torticollis bears advantages ofminimal invasion, little pain, quick recovery, high efficacy, and good cosmetic outcomes. The facial expression is unaffected.

参考文献/References:

[1]李龙,付京波,刘钢,等.内镜下胸锁乳突肌切断治疗肌性斜颈的初步报告.临床小儿外科杂志,2004,3(2):81-84.
[2]柳江太.先天性肌性斜颈的手术治疗.实用口腔医学杂志,1999,15(1):362.
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[4]刘玉杰,陈继营,贾金鹏,等.关节镜下射频汽化松解治疗青少年先天性肌斜颈.中国微创外科杂志,2005,5(7):563-564.

备注/Memo

备注/Memo:
①（北京大学第一医院小儿外科,北京,100034）
更新日期/Last Update: 2014-02-13