Department of Paediatrics, Institute of Clinical Sciences at the Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden.
Dev Med Child Neurol. 2010 Jun;52(6):529-34. doi: 10.1111/j.1469-8749.2009.03479.x. Epub 2009 Dec 23.
The aim of this investigation was to study the incidence of obstetric brachial plexus palsy (OBPP), to prospectively follow the recovery process, to assess the functional outcome at 18 months of age, and to find early prognostic indicators.
Of the 38 749 children born between 1999 and 2001 in western Sweden, 114 (70 males, 44 females) had an OBPP. Ninety-eight children were examined on six occasions at up to 18 months of age. Muscle strength, range of motion, hand preference, and functional abilities were noted, and the severity of the OBPP was classified.
The incidence of OBPP was 2.9 per 1000 live births, and the incidence of persisting OBPP was 0.46 per 1000. At 3 months of age, the predictive value of regained elbow flexion for complete recovery was 100%, 99% of shoulder external rotation, and 96% of forearm supination. Most of the 18 children with persisting OBPP could perform functional activities but asymmetries were noted. Five children had a mild, 11 had a moderate, and two had a severe impairment. Three had undergone nerve surgery, one with a mild and two with a severe persisting impairment.
Most children with an OBPP recover completely. Muscle strength at 3 months of age can be used to predict outcome.
本研究旨在调查产科臂丛神经麻痹（OBPP）的发生率，前瞻性随访其恢复过程，评估 18 个月时的功能结局，并寻找早期预后指标。
在 1999 年至 2001 年期间，瑞典西部出生的 38749 名儿童中，有 114 名（70 名男性，44 名女性）患有 OBPP。98 名儿童在 18 个月之前接受了 6 次检查。记录肌肉力量、活动范围、手偏好和功能能力，并对 OBPP 的严重程度进行分类。
OBPP 的发生率为每 1000 例活产 2.9 例，持续性 OBPP 的发生率为每 1000 例 0.46 例。3 个月时，恢复肘部弯曲对完全恢复的预测值为 100%，肩部外旋为 99%，前臂旋前为 96%。18 名持续性 OBPP 儿童中，大多数可以进行功能活动，但存在不对称。5 名儿童轻度受损，11 名中度受损，2 名重度受损。3 名儿童接受了神经手术，1 名轻度和 2 名重度持续性受损。
大多数 OBPP 患儿可完全恢复。3 个月时的肌肉力量可用于预测结局。
