臂丛神经麻痹：出生第一年的发病率、自然病程和预后因素。
Brachial plexus birth palsy: incidence, natural-course, and prognostic factors during the first year of life.
机构信息
The Hebrew University School of Medicine, Jerusalem, Israel.
Department of Orthopedic Surgery, Shaare Zedek Medical Center, The Hebrew University School of Medicine, Jerusalem, Israel.
出版信息
J Perinatol. 2021 Jul;41(7):1590-1594. doi: 10.1038/s41372-021-00972-4. Epub 2021 Mar 31.
OBJECTIVE
To evaluate the incidence of brachial plexus birth palsy (BPBP) in a large, single cohort and stratify clinical 1-year outcomes.
STUDY DESIGN
A cohort study of all births occurring at a single institution between 2011 and 2015. Hospital discharge papers were analyzed, and structured telephone interviews were conducted.
RESULTS
Among 76,000 livebirths, 98 (0.13%) cases of BPBP were diagnosed. Of cases who fully responded to interview (66/98), at 3 months of age 77% infants made a complete recovery, and by 1 year of age an additional 20% had recovered completely. Only 3% of infants had residual longer-term neurological deficits.
CONCLUSIONS
Predictors of a longer course of recovery were the presence of shoulder dystocia (p < 0.04) and right-sided palsy (p < 0.02). Birth weight, neonatal head circumference, and sex were not correlated with outcome. Future reports of BPBP should differentiate between infants showing early recovery from those with true BPBP.
目的
在一个大型单队列中评估臂丛神经产伤（BPBP）的发生率，并对临床 1 年结局进行分层。
研究设计
这是一项对 2011 年至 2015 年期间在一家机构发生的所有活产儿进行的队列研究。分析了医院出院记录，并进行了结构化电话访谈。
结果
在 76000 例活产儿中，诊断出 98 例（0.13%）BPBP。在接受全面访谈的病例中（66/98），3 月龄时 77%的婴儿完全恢复，1 岁时又有 20%完全恢复。只有 3%的婴儿有长期的神经功能缺损。
结论
恢复时间较长的预测因素是存在肩难产（p<0.04）和右侧麻痹（p<0.02）。出生体重、新生儿头围和性别与结局无关。未来关于 BPBP 的报告应区分早期恢复的婴儿和真正的 BPBP 婴儿。
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