目的 了解苏州地区婴幼儿发育性髋关节发育不良(DDH)发生率,探讨超声筛查在幼儿DDH诊断中的临床价值。方法 2018年1-12月在苏州市立医院儿童保健科经临床检查高度怀疑DDH的6 009例,共12 018个髋关节,采用Graf高频超声技术观察婴幼儿髋关节形态,测量 α、β 角并进行分型,对结果进行统计分析。结果 本次调查正常髋关节5 479例,DDH发病率为5.999%/(721/12 018),女性DDH的检出率高于男性(χ2=133.74,P<0.001)、左侧DDH的检出率高于右侧(χ2=12.22,P=0.002)。结论 超声检查能有效地评估幼儿髋关节的发育,是婴幼儿DDH早期筛查和随访的主要手段,为早期诊断、早期治疗起到了重要作用。
Abstract
Objective To investigate the incidence of developmental hip dysplasia(DDH) among infants in Suzhou,in order to explore the clinical value of ultrasound screening in the diagnosis of DDH. Methods A total of 6 009(12 018 hips) infants suspected for DDH were selected as the participants in Soochow Municipal Hospital from January to December in 2018.All infants suspected for DDH were examined by ultrasonography,the α and β angles were measured and the category was made based on Results. Results There were 5 479 cases of normal hip joint and the incidence of DDH was 5.999%(721/12 018).The detection rate of DDH in female infants was significantly higher than that in male ones(χ2=133.74,P<0.001).Also,the detection rate of DDH in left hips was significantly higher than that in right hips(χ2=12.22,P=0.002). Conclusions Ultrasonic examination can assess the development of hips effectively.It can serve as a major method for early screening and follow-up of DDH in infants,and thus plays an important role in early intervention treatment.
关键词
婴幼儿 /
发育性髋关节发育不良 /
Graf超声筛查
Key words
infants /
developmental dysplasia of the hip /
Graf untrasonic screening
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] de Hundt M,Vlemmix F,Bais JM,et al.Risk factor for developmental dysplasia of the hip:a meta-analysis[J] .Eur J Obstet Gynecol Reprod Biol,2012,165(1):8-17.
[2] Engesaeter IØ,Lie SA,Lehmann TG,et al.Neonatal hip instability and risk of total hip replacement in young adulthood[J] .Acta Orthop,2008,79(3):321-326.
[3] 中华医学会小儿外科分会骨科学组,中华医学会骨科学分会小儿创伤矫形学组.发育性髋关节发育不良临床诊疗指南(0~2岁)[J] .中华骨科杂志,2017,37(11):641-650.
[4] Mulpuri K,Song KM,Goldberg MJ,et al.Detection and nonoperative management of pediatric developmental dysplasia of the hip in infants up to six months of age[J] .J Am Acad Orthop Surg,2015,23(3):202-205.
[5] Graf R.The diagnosis of congenital hip-joint dislocation by the ultrasonic combound treatment[J] .Arch Orthop Trauma Surg,1980,97(2):117-133.
[6] Loder RT,Skopelja EN .The epidemiology and demographics of hip dysplasia[J] .ISRN Orthopedics,2014,2011(3):2 38607.
[7] 李贞,张娜,张铁娟,等.超声检查对婴幼儿髋关节发育不良的产前高危因素筛选研究[J] .中国生育健康杂志,2017,28(6):529-532.
[8] Schaeffer EK,Study GI,Mulpuri K.Developmental dysplasia of the hip:addressing evidence gaps with a multicentre prospective international study[J] .Med J Aust,2018,208(8):359-364.
[9] Riccabona M,Schweintzger G,Grill F,et al.Screening for developmental hip dysplasia(DDH)-clinically or sonographically? Comments to the current discussion and proposals[J] .Pediatric Radiol,2013,43(5):637-640.
[10] Shaw BA,Segal LS.Evaluation and referral for developmental dysplasia of the hip in infants[J] .Pediatrics,2016,138(6):e20163107.
[11] Ortiz-Neira CL,Paolucci EO,Donnon T.A meta-analysis of common risk factors associated with the diagnosis of developmental dysplasia of the hip in newborns[J] .Eur J Radiol,2012,81(3):e344-e351.
[12] Talbot CL,Paton RW.Screening of selected risk factors in developmental dysplasia of the hip:an observational study[J] .Arch Dis Child,2013,98(9):692-696.
[13] Su PY,Huang K,Hao JH,et al.Maternal thyroid function in the first twenty weeks of pregnancy and subsequent fetal and infant development:a prospective population-based cohort study in China[J] .J Clin Endocrinol Metab,2011,96(10):3234-3241.
[14] Sezer C,Unlu S,Demirkale I,et al.Prevalence of developmental dysplasia of the hip in preterm infants with maternal risk factors[J] .J Child Orthop,2013,7(4):257-261.