新生儿臂丛神经损伤后早期手功能训练对患儿臂丛神经康复的应用研究

Early hand function training for recovery of brachial plexus after brachial plexus injury in neonates

目的探讨新生儿臂丛神经损伤后，早期手功能训练对患儿臂丛神经康复的效果。方法选取2011年9月至2014年9月于本院进行新生儿臂丛神经损伤治疗的患儿72例，随机分为两组，36例患儿进行常规康复治疗作为对照组，另36例患儿在对照组的基础上进行早期手功能训练作为观察组，比较两组患儿干预前后的神经肌电图（MCV）检查情况、患肢动脉血流情况及康复总有效率。结果早期手功能训练对各类型的损伤恢复均有较好的效果，观察组总有效率为97．22％，显著高于对照组的83．33％（P〈0．05）。每组共检测神经数目为144条，早期手部训练前，两组患儿MCV检查情况及血流情况无差异，而训练6周、12周后，观察组的上述指标均优于对照组（均P〈0．05）。结论早期手功能训练对新生儿臂丛神经损伤有显著的康复效果，值得临床应用并加以推广。

Objective To explore the effect of early hand function training for the recovery of brachial plexus in neonates with brachial plexus injury. Methods 72 neonates with brachial plexus injury treated at our hospital from September, 2011 to September, 2014 were selected and randomly divided into a control group （n=36）, given conventional rehabilitation therapy, and an observation group （n=36）, given conventional rehabilitation therapy and early hand function training. Before and after the intervention, the neural EMG condition （ MCV ） , arterial flow, and total rehabilitation effective rate were compared. Results Early hand function training had good effect on all types of injury. The total effective rate of the observation group was 97.22%, which was significantly higher than that of the control group （83.33%）（P 〈 0.05）. 144 nerves were detected in both groups; before the training, there were no statistical differences in the MCV and blood flow between these two groups; 6 and 12 weeks after the training, the MCV and blood flow were better in the observation group than in the control group （P 〈 0.05）. Conclusion Early hand function training for the recovery ofbrachial plexus in neonates with brachial plexus injury is effcitve, so it is worth being clinically generalized.