39例分娩性臂丛神经损伤新生儿的神经电生理评价

目的:探讨新生儿期电生理检测在评价分娩性臂丛神经损伤中的价值。方法:应用肌电一诱发电位仪对39例分娩性臂丛神经损伤新生儿进行检测。测试项目包括:①患侧臂丛神经五大分支腋神经、肌皮神经、正中神经、尺神经及桡神经运动神经传导速度测定;患侧正中神经、尺神经及桡神经感觉神经传导速度测定;②采用同芯针电极检测臂丛神经支配远端肌肉(三角肌、肱二头肌、4伸指总肌、外展拇短肌、外展小指肌或骨问肌)肌电图。结果:39例新生儿中全臂丛神经损伤11例(28％);上干损伤18例(46％);下干损伤3例(8％);后束损伤7例(18％)。节前损伤11例(28％)。结论:新生儿期神经电生理检测对早期评价分娩性臂丛神经损伤的范围、性质、部位及程度具有重要的临床价值。

Electrophysiological assessment of birth-related brachial plexus injures in 39 newborns

Objective:To explore the value of the electrophysiological determination in assessing birth-related brachial plexus injures in newborns. Methods: Thirty-nine new borns underwent the examinations including regular electromyography (deltoid, biceps brachii, extensor digitorum communis, abductor pollicis brevis, and abductor digiti minimi or dorsal interossei), nerve conduction velocity of the brachial plexus (axillary nerve, musculo cutaneous nerve, radial nerve, median nerve, and ulnar nerve) by using a Viking IV recorder. Results: Eleven(28%) newborns had pan-plexus, eighteen(46%) upper plexus, three(8%) lower plexus and seven(18%) posterior cord involvements. Eleven(28%) newborns were confirmed with preganglionic axon lesion. Conclusions: The electrophysio logical determination might be of important value in the diagnosis of the limits, property, position and degree of brachial plexus injures in newborns.