Strömbeck Christina, Krumlinde-Sundholm Lena, Remahl Sten, Sejersen Thomas
Department of Neuropaediatrics, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.
Dev Med Child Neurol. 2007 Mar;49(3):198-203. doi: 10.1111/j.1469-8749.2007.00198.x.
The aims of this study were to describe the development of sequelae in obstetric brachial plexus palsy (OBPP) and to identify possible differences in functional outcome from 5 years of age to follow-up, 2 to 15 years later. A cohort of 70 participants (35 males, 35 females; age range 7-20y, mean 13y 6mo [SD 4y 3mo], median 13y) with OBPP of varying degrees of severity were monitored. Differences in status between 5 years of age and follow-up were studied. Active joint motion in the shoulder and hand function, especially grip strength, generally remained unchanged or improved, whereas a slight but significant deterioration occurred in elbow function. Shoulder surgery resulted in considerable improvement of shoulder function. Participants with nerve reconstruction had a similar profile of change as the non-operated group. It was concluded that ongoing follow-up of children with OBPP, beyond the preschool years, is required due to decreases in elbow function, a commonly occurring restriction in external rotation of the shoulder, together with individual variations in long-term outcomes. In a related article (part II: neurophysiological aspects) long-term neurophysiological and sensory aspects of OBPP are reported.
本研究的目的是描述产科臂丛神经麻痹（OBPP）后遗症的发展情况，并确定从5岁到随访时（2至15年后）功能结局可能存在的差异。对70名患有不同严重程度OBPP的参与者（35名男性，35名女性；年龄范围7 - 20岁，平均13岁6个月[标准差4岁3个月]，中位数13岁）进行了监测。研究了5岁时与随访时状态的差异。肩部的主动关节活动和手部功能，尤其是握力，总体上保持不变或有所改善，而肘部功能则出现了轻微但显著的恶化。肩部手术使肩部功能有了相当大的改善。接受神经重建的参与者与未手术组的变化情况相似。得出的结论是，由于肘部功能下降、肩部外旋常见受限以及长期结局的个体差异，OBPP患儿在学龄前之后仍需要持续随访。在一篇相关文章（第二部分：神经生理学方面）中报告了OBPP的长期神经生理学和感觉方面的情况。
