Obstetrik Brakial Pleksus Felci

Yıl 2020, Cilt: 2 Sayı: 2, 47 - 52, 29.06.2020

Seyyid Şerif Ünsal , Mehmet Armangil

Öz

Obstetrik brakial pleksus felci (OBPF), brakial pleksusu oluşturan sinir yapılarının (C5, C6, C7 ,C8 ve T1) perinatal dönemde zedelenmesi sonucu oluşan, üst ekstremitede kısmi veya tam flask paralizi ile seyreden ciddi bir klinik tablodur. Türkiyede görülme sıklığı 1000 canlı doğumda %0,9 olarak bildirilmiştir. OBPF’ nin en önemli risk faktörleri olarak fetal makrozomi (fetal ağırlık > 4,000 g ) pelvik doğum ve omuz distozisi sayılabilir. OBPF’li hastaların büyük kısmı kendiliğinden iyileşmekte, ancak geri kalan hasta grubunda ise ciddi engellilik kalmaktadır. Klinik seyir ilk yaralanmanın tipi (nöropraksi, rüptür, avülsiyon vb.) ve etkilenen kökler (üst, alt, orta ve total brakial pleksus felci ) ile yakından ilişkilidir. Yaralanmanın şiddetini değerlendirmek için kullanılan iki önemli radyolojik yöntem Bilgisayarlı tomografi miyelografi ve Manyetik rezonans görüntülemedir. Bu hastaların OBPF ile ilgilenen merkezlerce takibinin yapılması ve uygun cerrahi zamanın belirlenmesi gerekmektedir.
anahtar kelimeler: Yenidoğan Brakial Pleksus Felci, Periferik sinirler, Epidemiyoloji, Cerrahi
Obstetric brachial plexus palsy (OBPF) is a serious clinical entity that occurs with partial or full flaccid paralysis in the upper extremity, which is formed as a result of damage to the nervous structures (C5, C6, C7, C8 and T1) forming the brachial plexus in the perinatal period. The incidence reported in Turkey is 0.9% per 1,000 live births. Fetal macrosomia (fetal weight> 4,000 g) pelvic birth and shoulder dystocia can be considered as the most important risk factors of OBPF. The majority of patients with OBPF recover spontaneously, but the remaining group of patients remains severely disabled. The clinical course is closely related to the type of first injury (neuropraxia, rupture, avulsion, etc.) and the affected roots (upper, lower, middle and total brachial plexus palsy). Two important radiological methods used to evaluate the severity of injury are computed tomography myelography and magnetic resonance imaging. These patients should be followed up by the centers dealing with OBPF and the appropriate surgical time should be determined.
key words: Neonatal Brachial Plexus Palsy, Peripheral Nerves, Surgery, Epidemiology

Anahtar Kelimeler

Yenidoğan Brakial Pleksus Felci, Periferik sinirler, Epidemiyoloji, Cerrahi

Kaynakça

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