Gottlieb M S
Logan College of Chiropractic, St. Louis, MO.
J Manipulative Physiol Ther. 1993 Oct;16(8):537-43.
A review of the medical literature was undertaken to determine cause, diagnosis, prognosis, treatment and prevention of injuries resulting from birth trauma. The primary focus was the neonate, though infant, child and adult were also considered because the effects of birth trauma can be life-long.
A compilation of case studies and review articles were extracted from numerous "MEDLINE" literature searches. Key Terms included: Birth Trauma, Central Nervous System Injuries, Musculoskeletal Injuries, Stillbirth, Sudden Infant Death Syndrome (SIDS), Cerebral Palsy, Brachial Plexus Palsies (Erb's and Klumpke's), Neonatal-Infantile Respiratory Distress, Obstetric Accidents (Forceps, Vacuum Cup and Cesarean Deliveries), Subluxation, Chiropractic Treatment. American, British, Danish and German studies were included to show the universality of the problem.
Findings were selected on the basis of a clear connection between birth trauma and the resulting symptoms, syndromes and/or death.
Findings were compiled by studying articles from the literature search. The quality and validity were assessed by corresponding references, method of documentation, number of case studies, length of time over which studies took place and presence of follow-up documentation.
Inadequacies and source discrepancies were also included with regard to cause and types of obstetric accidents.
Birth trauma remains an underpublicized and, therefore, an undertreated problem. There is a need for further documentation and especially more studies directed toward prevention. In the meantime, manual treatment of birth trauma injuries to the neuromusculoskeletal system could be beneficial to many patients not now receiving such treatment, and it is well within the means of current practice in chiropractic and manual medicine.
对医学文献进行综述,以确定出生创伤所致损伤的原因、诊断、预后、治疗及预防。主要关注新生儿,不过婴儿、儿童及成人也在考虑范围内,因为出生创伤的影响可能是终身的。
从众多“医学在线”文献检索中提取了一系列病例研究和综述文章。关键词包括:出生创伤、中枢神经系统损伤、肌肉骨骼损伤、死产、婴儿猝死综合征(SIDS)、脑瘫、臂丛神经麻痹(产瘫和克伦普克麻痹)、新生儿 - 婴儿呼吸窘迫、产科意外(产钳、真空吸引器及剖宫产)、半脱位、整脊治疗。纳入了美国、英国、丹麦及德国的研究以表明该问题的普遍性。
根据出生创伤与所产生的症状、综合征和/或死亡之间的明确关联来选择研究结果。
通过研究文献检索中的文章来汇编研究结果。通过相应参考文献、文献记录方法、病例研究数量、研究进行的时间长度及随访记录的存在情况来评估质量和有效性。
还纳入了关于产科意外原因和类型的不足之处及来源差异。
出生创伤仍然是一个宣传不足且因此治疗不足的问题。需要进一步记录,尤其是更多针对预防的研究。与此同时,对神经肌肉骨骼系统出生创伤损伤进行手法治疗可能对许多目前未接受此类治疗的患者有益,并且这完全在整脊医学和手法医学当前的实践范围内。