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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 investigate the incidence of neonatal brachial plexus injury (NBPP) and the related risk factors through the investigation of neonatal status in Jiangsu Province. Methods Data of obstetric and gynecological maternal and childbirth from 2001 to 2005 in three counties and cities of Jiangsu Province, representing different economic levels and regions, were randomly collected. The chi-square test or Fisher’s exact test were used to analyze the risk factors of NBPP. Results In the 14321 survey data, no records of NBPP children were found. The incidence of cesarean section, fetal birth rate, occipital transverse / posterior position, extension of second stage of labor and Apgar 1/5-min <8 was significantly different in different years in different counties / cities (P <0.01) . In counties and cities, the rates of peer-to-peer delivery and macrosomia were statistically significant (P <0.01). Conclusions The NBPP risk factors in the survey data did not show any decrease. It is speculated that the incidence of NBPP in Jiangsu Province is ≥1.00 ‰. Many obstetric workers lack awareness of neonatal brachial plexus injury; we should strengthen the monitoring of neonatal conditions in China, is conducive to early detection of brachial plexus injury, early treatment.