小结
定义
病史和体格检查
关键诊断因素
- 单侧手臂麻痹
- 观察到某一手臂活动度下降
- 手臂姿势异常
其他诊断因素
- 锁骨或肱骨劈啪声
- Horner 综合征
- 呼吸急促、呼吸窘迫、喂食困难、生长迟缓
- 被动运动关节活动度降低
- 反射亢进、持续性原始反射、肌张力异常或身体姿势异常
危险因素
- 婴儿体型偏大（>4000g）
- 肩难产
- 孕妇糖尿病（尤其是1型）或妊娠糖尿病
- 产妇肥胖
- 臀先露
- 第二产程异常
- 接受辅助的分娩
诊断性检查
首要检查
- 胸部和患侧上肢 X 线检查
需考虑的检查
- 肩部超声扫描
- 肩部核磁共振成像（MRI）
- 肩部计算机断层扫描（CT）扫描
- EMG /神经传导检查
新兴检查
- 用于评估臂丛神经的三维质子密度 MRI
- 肩袖肌肉的容积 MRI 与 EMG 评估
- 臂丛神经的超声评估
治疗流程
新生儿及婴幼儿
初始治疗之后
撰稿人
作者
Mark J. Adamczyk, MD
Co-Director
Brachial Plexus Treatment Center
Vice-Chairman
Department of Pediatric Orthopedic Surgery
Akron Children's Hospital
Akron
OH
利益声明
MJA declares that he has no competing interests.
Stephanie A. Russo, MD, PhD
Co-Director
Brachial Plexus Treatment Center
Pediatric Hand and Peripheral Nerve Surgery
Akron Children’s Hospital
Akron
OH
利益声明
SAR declares that she has no competing interests.
同行评议者
Dimitrios I. Zafeiriou, MD, PHD
Assistant Professor in Child Neurology and Developmental Pediatrics
1st Department of Pediatrics
Aristotle University of Thessaloniki
Thessaloniki
Greece
利益声明
DIZ is an author of a reference cited in this topic.
Marybeth Ezaki, MD
Professor of Orthopedic Surgery
UT Southwestern Medical School
Director of Hand Surgery
Texas Scottish Rite Hospital for Children
Dallas
TX
利益声明
ME is an author of a number of references cited in this topic.
Scott H. Kozin, MD
Professor
Orthopaedic Surgery
Temple University
Hand and Upper Extremity Surgeon
Shriners Hospitals for Children
Philadelphia
PA
利益声明
SHK is an author of a reference cited in this topic.
鉴别诊断
- 锁骨或肱骨骨折
- 肩膀脓毒性关节炎或近端肱骨骨髓炎
- 脊髓或臂丛肿瘤
更多 鉴别诊断指南
- 新生儿臂丛神经麻痹的评估和管理
- 肩难产
更多 指南
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