新生儿臂丛神经损伤康复 [早期康复干预对新生儿臂丛神经损伤修复的影响观察]

　　[摘要] 目的 探讨早期康复干预对新生儿臂丛神经损伤修复的影响。 方法 选取2008年3月～2011年9月于江苏省徐州市儿童医院进行治疗的32例新生儿臂丛神经损伤患儿为对照组，进行常规的治疗及康复，同期的32例患儿为观察组，在对照组基础上早期进行细致及针对性的康复干预，然后将两组患儿的总有效率及干预前、干预后6、12周的神经肌电图（MCV）检查情况、患肢动脉血流情况进行比较。 结果 观察组的总有效率高于对照组，MCV检查情况、患肢动脉血流情况改善均优于对照组（均P ＜ 0.05）。 结论 早期康复干预对新生儿臂丛神经损伤修复的影响非常明显，综合优势较为突出。
　　[关键词] 早期康复干预；新生儿臂丛神经损伤；影响
　　[中图分类号] R722.14+4 [文献标识码] A [文章编号] 1673-7210（2012）08（b）-0043-02
　　Observation of the influence of early rehabilitation intervention on the repair of neonatal brachial plexus injury
　　WU Ye1 YANG Zhongxiu1 WU Jie2
　　1.Department of Rehabilitation, the Children′s Hospital of Xuzhou City, Jiangsu Province, Xuzhou 221006, China; 2. Department of Rehabilitation, the Central Hospital of Xuzhou City, Jiangsu Province, Xuzhou 221006, China
　　[Abstract] Objective To study the influence of early rehabilitation intervention on the repair of neonatal brachial plexus injury. Methods 32 neonatal brachial plexus injury in our hospital from March 2008 to September 2011 were selected as control group, and they were intervened with routine rehabilitation intervention, and 32 patients at the same time were selected as observation group, and they were intervened with early targeted rehabilitation intervention, then the total effective rate and MCV detection situation and affected limb arterial blood stream before and after the intervention at sixth and twelfth week of two groups were compared. Results The total effective rates of observation group were higher than those of control group, improvement of MCV detection situation and affected limb arterial blood stream were all better than those of control group, there were all significant differences (all P ＜ 0.05). Conclusion The influence of early rehabilitation intervention for the repair of neonatal brachial plexus injury is obvious, and the comprehensive advantage is better.
　　[Key words] Early rehabilitation intervention; Neonatal brachial plexus injury; Influence
　　新生儿臂丛神经损伤主要是由生产过程中的异常情况导致，患儿表现出患肢松弛悬垂于体侧，不能做外展、外旋及屈肘等活动，较多研究认为如不能早期进行治疗干预，尤其是6个月后进行治疗者，预后较差[1-2]。而对于极早期的康复及训练方面的干预效果仍需进一步探讨研究。本文中笔者就早期康复干预对新生儿臂丛神经损伤修复的影响进行观察，具体情况如下：
　　1 资料与方法
　　1.1 一般资料
　　选取2008年3月～2011年9月于江苏省徐州市儿童医院进行治疗的32例新生儿臂丛神经损伤患儿为对照组，同期的32例患儿为观察组。对照组的32例患儿中，男18例，女14例；年龄0.5～10.8个月，平均（2.7±0.2）个月；出生体重为3 218～5 004 g；平均（3 708.9±205.4）g；生产方式：顺产30例，剖宫产2例；其中上干型13例，下干型8例，全臂型11例。观察组的32例患儿中，男17例，女15例；年龄0.5～11.0个月，平均（2.6±0.3）个月，出生体重为3 250～5 002 g，平均（3 714.5±202.3）g；生产方式：顺产29例，剖宫产3例；其中上干型14例，下干型8例，全臂型10例。两组患儿的性别、年龄、生产方式及病变部位差异无统计学意义（P ＞ 0.05），具有可比性。