在诊所中Sup-ER协议的建立如何改变了上臂 (Erb类型) 出生损伤的程序模式
Vanessa Choi Yin Wong1, Darius Balumuka2, Young Ji Tuen1
1University of British Columbia, Vancouver, Canada.
概括
婴儿肩部重新定位协议 (Sup-ER) 减少了对上腕出生损伤的儿童进行臂探索和移植手术的需要. 神经移植变得比移植更受欢迎,用于手术干预.
科学领域:
- 儿科整形外科 儿科整形外科
- 儿科神经外科 儿科神经外科
- 出生伤害管理的管理.
背景情况:
- 上腕出生损伤 (BPBI) 通常涉及非手术管理,随后是手术干预.
- 2008年实施了一项婴儿肩部重新定位方案 (置-外部旋转[Sup-ER]) 以防止肩部收缩.
- 这项研究比较了在采用Sup-ER协议之前和之后接受治疗的患者的干预措施.
研究的目的:
- 描述临床目前对上部BPBI的程序干预.
- 为了比较使用Sup-ER协议和历史对照的患者之间的干预的选择,数量和时间.
主要方法:
- 从2001年至2018年接受上部BPBI手术的患者的回顾性审查.
- 将患者分为历史的 (2001-2007) 和最近的 (2008-2018) 队列.
- 对患者人口统计,手术类型/时间以及功能性结果的分析.
主要成果:
- 在Sup-ER协议建立后,手臂探索和移植 (BPEG) 手术的数量较少.
- 在婴儿后期,神经转移比BPEG更受青.
- 更多的和更早的博托克斯注射被管理,与较少的肌移植和更高的术前功能进行移植的那些.
结论:
- 补充ER协议与BPEG手术的指示较少有关.
- 直接神经转移越来越多地比BPEG用于婴儿的手术神经修复.
- 肩肌转移率有所下降,某些骨切除术不再进行.
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