分娩性臂丛神经损伤患儿肢长的横断面研究  

A cross-sectional study of limb length in children with obstetric brachial plexus palsy

作　　者：陆宏晴 方东翔 李放 马立宏 刘越 须燕玲 张沁怡 高志强 Lu Hongqing;Fang Dongxiang;Li Fang;Ma Lihong;Liu Yue;Xu Yanling;Zhang Qinyi;Gao Zhiqiang(Department of Rehabilitation Medicine,Baoshan Renhe Hospital,Shanghai 201900,China;Department of Rehabilitation Medicine,Huashan Hospital Affiliated to Fudan University,Shanghai 200040,China)

机构地区：[1]上海市宝山区仁和医院康复医学科,上海201900 [2]复旦大学附属华山医院康复医学科,上海200040

出　　处：《中华手外科杂志》2022年第6期493-498,共6页Chinese Journal of Hand Surgery

基　　金：上海市卫计委基金资助项目(20194Y0340)。

摘　　要：目的为了解分娩性臂丛神经损伤(obstetric brachial plexus palsy,OBPP)患儿肢长情况,双上肢肢长差是否受年龄及神经损伤程度影响,为OBPP康复管理提供肢体发育方面的信息。方法该横断面研究选取153例OBPP患儿(Ⅱ型86例、Ⅲ型8例、Ⅳ型59例),测量并记录双上肢上臂、前臂、手掌、手指长度,计算健侧和患侧差值。检验不同神经损伤分型组中的各段肢长差值的差异性,比较患儿月龄与各段肢长差值的相关性。结果患儿上臂差在不同分型组中差异无统计学意义(P=0.121),前臂差在不同分型组中差异有统计学意义(P=0.034),掌长差在不同分型中差异有统计学意义(P=0.006),指长差在不同分型中差异有统计学意义(P<0.001)。患儿月龄与上臂差相关系数r=0.211(P=0.009),月龄与前臂差相关系数r=0.335(P<0.001),患儿月龄与指长差相关系数r=0.416(P<0.001),患儿月龄与掌长差无明显相关性。结论仑患儿神经损伤程度越严重,双侧肢长差距越大。患儿年龄越大,双侧肢长差距越大。ObjectiveTo understand the limb length of children with obstetric brachial plexus palsy(OBPP),and whether the difference in the length of both upper limbs is affected by age and the degree of nerve injury,so as to provide information on limb development for the rehabilitation management of OBPP.Methods In this cross-sectional study,153 children with OBPP(86 cases of typeⅡ,8 cases of typeⅢand 59 cases of typeⅣ)were selected.The lengths of the upper arms,forearms,palms and fingers of both upper limbs were measured and recorded,and the difference between the healthy side and the affected side was calculated.The difference of limb length in different nerve injury classification groups was tested,and the correlation between the age of children and the difference of limb length was compared.Results There was no significant variation in upper arm length difference among various types(P=0.121).There was significant variation in forearm length difference among various types(P=0.034).There was significant variation in palm length difference among various types(P=0.006).There was significant difference in finger length difference among various types(P<0.001).The correlation coefficient between the child's age and upper arm differencer was 0.211(P=0.009),the correlation coefficient between the child's age and forearm difference r was 0.335(P<0.001),and the correlation coefficient between the child's age and finger length dfference r was0.416(P<O.001).There was no significant correlation between the child's age and palm length difference.Conclusion The more severe the degree of nerve injury in children,the greater the difference of bilateral limb length.The older the child is,the greater the difference in bilateral limb length is.

关 键 词：臂丛 横断面研究 分娩性臂丛神经损伤 肢体短缩 骨骼发育 

分 类 号：R726.8[医药卫生—儿科]