产伤致臂丛神经损害的临床和电生理分析

目的　探讨产伤所致婴幼儿臂丛神经及其分支损害的临床和电生理表现。方法　对 2 5例患儿结合其临床表现 ,分析正中神经、尺神经、桡神经、肌皮神经、腋神经、肩胛上神经感觉及运动传导速度 (末端潜伏期 )、F波 ,并用同心圆针电极观察拇短展肌、小指展肌、指总伸肌、肱二头肌、肱三头肌、三角肌、冈上肌的肌肉的病理自发电位及募集形式。结果　产伤的婴儿男性略多于女性 (16 /9) ,10 6条运动神经在不同节段收集共有 84条异常 (79% ) ;70条感觉神经有 5 2条异常 (70 .5 % ) ;2 5例中F波异常 6例 (2 4 % )。检测 12 6块肌肉 ,其中 6 4块肌肉静止状态时出现两处或两处以上纤颤电位和 (或 )正锐波 ;5 4块肌肉重收缩时无运动单位 ,2 0块肌肉募集电位明显减少。结论　电生理检测对确定受损神经、损害性质、损害程度以及预后有重要价值。

Clinical and electrophysiological analysis of brachial plexus nerve damage following childbirth

Objective To investigate the clinical and electrophysiological findings of brachial plexus nerve damage following childbirth .Methods 25 cases were summarized,in which the motor and sensory conduction velocity of nerves including median ulnar radial musculocutaneous axillary and suprascapular nerves were studied,F-wave were analyzed too. The pathological spontaneous electric activities and the pattern of motor unit recruitment of muscles were observed with the concentric needle electromyographic examinations,in which muscles containing abductor pollicis brevis,abductor digiti minimi,extensor digitorum,biceps brachii,bicep brachii,deltoid,supraspinatus. Results Of 25 patients there were 16 males and 9 females,involving male more than female(16/9).Abnormalities were noted in 84 out of 106 motor nerves (79%) and in 52 out of 70 sensory nerves (70.5%);Eight out of 25 F-wave latencies prolonge (24%).At least two localization fibrillation potentials and/or positive sharp waves occurred in 64 out of 126 resting muscles. The motor unit active potentials disappeared during maximal voluntary contraction in 54muscles and the recruitments deceased in 20 muscles. Conclusion The electrophysiological studies were of much significance in evaluating injury nerve,nature,severity and prognosis.