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目的探讨内窥镜下离断胸锁乳突肌治疗肌性斜颈的效果。方法在右侧腋窝的皮纹线内置入5mmTrocar,手持镜头将颈阔肌下的脂肪层组织与胸锁乳突肌下端的胸骨头和锁骨头表面的肌膜相分离,这样显露了肌肉同时形成了空间,将CO2气体冲入加压至6mmHg。颈中和颈下横纹内分别导入3mmTrocar和器械。用电凝或电切逐渐将所有胸锁乳突肌纤维束横断,同时松解胸锁乳突肌周围的纤维组织。结果采用以上方法治疗5例右肌性斜颈患儿,均在内窥镜下完成手术,手术时间45～135min,失血量极少,均少于1ml,1例患儿颈部切口处有轻微电灼伤,2周后自愈。术后患儿即可以进行颈部舒展活动训练,术后次日出院,随访3个月～1年,斜颈均矫正,颈部3mmTrocar切口和腋窝内5mm切口瘢痕不明显,颈部皮肤弹性好,无随表情异常活动现象。结论内镜下切断胸锁乳突肌治疗肌性斜颈具有微创、痛苦小、恢复快、效果好的优点,瘢痕不明显,美观而且不损伤颈阔肌,对表情活动无影响,是值得推广的治疗方法之一。
Objective To investigate the effect of endoscopic sternocleidomastoid muscle treatment of muscular torticollis. Methods 5mmTrocar was inserted into the dermatoglyphics on the right armpit. The hand-held lens separated the fatty layer tissue under the platysma muscle from the sarcoplasmic surface of the sternum and the surface of the clavicle under the sternocleidomastoid, thus revealing the simultaneous formation of muscle The space, the CO2 gas into the pressurized pressure to 6mmHg. Neck and neck under the stripes were introduced 3mmTrocar and instruments. With electrocoagulation or electrosurgical gradually all sternocleidomastoid muscle fiber bundle transection, while loosen sternocleidomastoid muscle around the fibrous tissue. Results The above method was used to treat 5 children with right muscular torticollis. All underwent endoscopic surgery. The operation time was 45 to 135 minutes and the amount of blood loss was extremely small, less than 1ml. One case had slight neck incision Electric burns, 2 weeks after healing. Children with postoperative neck stretch activities can be trained, discharged the day after surgery the next follow-up of 3 months to 1 year, all corrected torticollis, neck 3mmTrocar incision and axillary 5mm incision scar is not obvious, the neck skin elasticity is good , No abnormal activity with the expression of the phenomenon. Conclusion Endoscopic sternocleidomastoid muscle treatment of muscular torticollis has the advantages of minimally invasive, less pain, faster recovery, good effect, scar is not obvious, beautiful and does not damage the platysma, has no effect on expression activities, it is worth Promote the treatment of one.