葉爾氏麻痺因及預後之探討

Erb's Palsy: Etiology and Prognosis

韋有維(Yau-Wai Wai) ； 陳秋芬(Chue-Fun Chen)

《中華民國復健醫學會雜誌》 16期 (1988/12) Pp. 67-72

摘要

隨著醫學不斷的進步，孕婦的生產過程已受到周詳的監視，以確保產婦及胎兒的安全；但在分娩過程中仍有種種情形會對嬰兒造成傷害，臂叢神經損傷即是其中之一。1874年Erb氏﹝1﹞首度提出生產中第五、六頸神經形成之上支幹臂叢神經(upper trunk of brachial plexus)造成傷害，會使新生兒的肩膀外展(abduction)，外轉(external rotation)以及肘部彎屈(elbow flexion)的肌力受損，產生所謂”小費手”(waiter's tip)之變形。雖然目前其發生率已減少許多﹝2﹞，但是在國內這種病例仍然不少。本研究的目的是為了探討其發生因素及預後之情況，以供預防及治療這種病童的參考。

並列摘要

This study was carried out on 67 children with obstetric palsy in the Department of physical Medicine and Rehabilition of the National Taiwan. University. It revealed that birth weight of more than 3500 gm would have higher prevalence of the palsy. There was no significant evidence to support the palsy had any relationship to patient's sex, presentation, parity, mode of delivery and lateralization of the lesion.
The follow up intervals ranged from 3 months to 6 years, with the mean 2 years and 3 months. The recovery rate of these children was rather satisfactory. One year after the injury the ratio between functional and non-functional was 36.3%:63.6% In the second year it was 46.7%:53.5% and the third year was 68.2%:31.8%. This meant that three years later, two thirds of the Erb's palsy could achieve good recovery. The recovery pattern did not show any relation with the severity of muscle weakness at birth.
This study also concluded that sensory integration training on the affected arm should be performed as early as possible to facilitate the development of body image.