江苏新生儿臂丛损伤发病率及危险因素的调查分析

Survey and analysis of the incidence and risk factors of neonatal brachial plexus palsy in Jiangsu province of China

目的通过江苏省新生儿状况调查,了解新生儿臂丛损伤(NBPP)的发病率及危险因素的相关情况。方法随机采集代表不同经济水平和地域的江苏省三个县市级人民医院2001～2005年产科母婴资料,应用χ2检验或Fisher′s确切概率法分析NBPP危险因素的相关情况。结果在14321份调查资料中,未见NBPP患儿记录。不同年份、不同县/市剖宫产率、胎吸助产率、枕横/后位、第二产程延长及Apgar 1/5-min<8分发生率差异有统计学意义(P<0.01)。不同县、市产钳助产率、巨大儿发生率差异有统计学意义(P<0.01)。结论调查资料中的NBPP危险因素并没有显示减弱,推测江苏省NBPP发生率≥1.00‰。许多产科工作者对新生儿臂丛损伤的认识存在不足;应该加强对我国新生儿状况监控,有利于新生儿臂丛损伤早期发现、早期治疗。

Objective To study the neonate monitor and control status and the current status and risk factors of neonatal brachial plexus palsy（NBPP） in Jiangsu province of China.Methods The data of neonates and their mothers who delivered in three cities or counties and had different economy levels and sections typically in Jiangsu province of China from 2001 to 2005 were enrolled by stratified randomization. The risk factors for NBPP were analyzed by χ2 text or Fisher′s value probability.Results No record of NBPP was found in 14 321 cases.Difference in the incidence of Cesarean section,vacuum extractor,occiput transverse position（occiput posterior position）,prolonged second stage of labor and 1-and 5-min Apgar score 8 had statistical significance among different years and cities（P0.01）.But difference of the incidence of macrosomia and using forceps had statistical significance only among different cities（P0.01）.Conclusion According to that the risk factors for NBPP were not weakened,it is supposed that the incidence of NBPP is not less than 1.00% in Jiangsu province.The most obstetricians have poor understanding about NBPP.We should pay much attention to strengthening neonate monitoring and control program,which will be useful for early diagnosis and treatment of NBPP.