自然阴道分娩：臂丛神经麻痹的一个危险因素？

Spontaneous vaginal delivery: a risk factor for Erb's palsy?

作者信息

Gherman R B, Ouzounian J G, Miller D A, Kwok L, Goodwin T M

机构信息

Department of Obstetrics and Gynecology, University of Southern California School of Medicine, Los Angeles, USA.

出版信息

Am J Obstet Gynecol. 1998 Mar;178(3):423-7. doi: 10.1016/s0002-9378(98)70413-2.

DOI:10.1016/s0002-9378(98)70413-2

PMID:9539501

Abstract

OBJECTIVE

Our purpose was to determine whether Erb's palsies occurring in the absence of shoulder dystocia differ from those occurring after shoulder dystocia.

STUDY DESIGN

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.

RESULTS

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).

CONCLUSIONS

Erb's palsy occurring without shoulder dystocia may be a qualitatively different injury than that occurring with shoulder dystocia.

摘要

目的

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。

研究设计

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。

结果

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）。