Gherman R B, Ouzounian J G, Miller D A, Kwok L, Goodwin T M
Department of Obstetrics and Gynecology, University of Southern California School of Medicine, Los Angeles, USA.
Am J Obstet Gynecol. 1998 Mar;178(3):423-7. doi: 10.1016/s0002-9378(98)70413-2.
Our purpose was to determine whether Erb's palsies occurring in the absence of shoulder dystocia differ from those occurring after shoulder dystocia.
We compared the time course of resolution and incidence of persistent injury at 1 year of age in 17 cases of Erb's palsy without shoulder dystocia and 23 cases associated with shoulder dystocia.
The rate of persistence at 1 year was significantly higher in those Erb's cases without identified shoulder dystocia, 7 of 17 (41.2%) versus 2 of 23 (8.7%), p = 0.04. These cases of Erb's palsies also took longer to resolve (6.4 +/- 0.9 vs 2.6 +/- 0.7 months, p = 0.002), had a higher rate of associated clavicular fracture (12 of 17 vs 5 of 23, p = 0.006), and were more likely to occur in the posterior arm (10 of 15 vs 4 of 21, p = 0.009).
Erb's palsy occurring without shoulder dystocia may be a qualitatively different injury than that occurring with shoulder dystocia.
我们的目的是确定在无肩难产情况下发生的臂丛神经麻痹与肩难产之后发生的臂丛神经麻痹是否存在差异。
我们比较了17例无肩难产的臂丛神经麻痹病例和23例与肩难产相关的臂丛神经麻痹病例在1岁时的恢复时间进程和持续性损伤发生率。
在未发现肩难产的臂丛神经麻痹病例中，1岁时持续性损伤的发生率显著更高，17例中有7例（41.2%），而23例中有2例（8.7%），p = 0.04。这些臂丛神经麻痹病例的恢复时间也更长（6.4±0.9个月对2.6±0.7个月，p = 0.002），伴有锁骨骨折的发生率更高（17例中有12例对23例中有5例，p = 0.006），并且更有可能发生在手臂后侧（15例中有10例对21例中有4例，p = 0.009）。
无肩难产情况下发生的臂丛神经麻痹可能在性质上与肩难产时发生的臂丛神经麻痹不同。
