BMJ Best Practice
最后审核时间： 六月 2019
最近更新时间： 一月 2019

小结

定义

病史和查体

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
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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、发育不良
  • 被动运动关节活动度降低
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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
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诊断性检查

首要检查

  • 对受累上肢至胸部进行常规X光检查（又名为‘婴儿全身X线检查’）
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需要考虑的检查

  • 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
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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
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治疗流程

急性

新生儿及婴幼儿

疾病持续状态

初始治疗之后

贡献者

Co-Director

Brachial Plexus Treatment Center

Assistant Director of Pediatric Orthopedic Research

Akron Children's Hospital

Akron

OH

利益冲突披露
MJA declares that he is on the speakers' bureau for Orthopediatrics implant company and has received compensation to the Department of Orthopaedic Surgery at Akron Children's Hospital for his involvement. He declares that there is no relation of this agreement to the topic of his BMJ article.

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Assistant Professor in Child Neurology and Developmental Pediatrics

1st Department of Pediatrics

Aristotle University of Thessaloniki

Thessaloniki

Greece

利益冲突披露
DIZ is an author of a reference cited in this monograph.

Professor of Orthopedic Surgery

UT Southwestern Medical School

Director of Hand Surgery

Texas Scottish Rite Hospital for Children

Dallas

TX

利益冲突披露
ME is an author of a number of references cited in this monograph.

Professor

Orthopaedic Surgery

Temple University

Hand and Upper Extremity Surgeon

Shriners Hospitals for Children

Philadelphia

PA

利益冲突披露
SHK is an author of a reference cited in this monograph.

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