目的 分析髋关节临床筛查及髋关节超声检查对诊断发育性髋关节发育不良(DDH)的意义及早期干预效果。 方法 选择2016年7月-2018年6月首次在山东大学齐鲁医院(青岛)儿保门诊健康查体,发现临床髋关节筛查阳性的6个月以下婴儿,进行髋关节超声检查,超声诊断阳性的TypeⅡa患儿进行早期干预,分析超声阳性率及早期干预效果。结果 临床髋关节筛查阳性1485例,其中男623例,女862例。髋关节超声检查阳性174例,其中男50例(8.02%),女124例(14.39%)。122例TypeⅡa的患儿通过分腿抱,垫宽尿片,117例(95.94%)恢复正常,5例转诊小儿骨科。结论 采用临床髋关节筛查及髋关节超声检查可以早期发现DDH,早期干预方法简单,无痛苦,恢复率高。
Abstract
Objective To investigate the significance of clinical screening of hip joint and ultrasound examination of hip joint in the diagnosis of developmental dysplasia of the hip (DDH) and the effect of early intervention. Methods Infants under 6 months with positive hip screening results who took first physical examination in Pediatric Healthcare Clinic of Qilu Hospital (Qingdao) were enrolled in this study from July 2016 to June 2018. Children with positive ultrasound examination of type Ⅱa were given early intervention, and the positive rate of ultrasound as well as the effect of early intervention were analyzed. Results There were 1 485 infants with positive clinical screening result of the hip, including 623 males and 862 females. Ultrasound examination of the hip was positive in 174 cases, including 50 males (8.02%) and 124 females (14.39%). And 122 children with Type Ⅱa results were intervened by holding legs and padding wide diapers, of whom 117 cases (95.94%) recovered to normal status and 5 cases were referred to Pediatric Orthopaedics Department. Conclusions DDH can be detected early by clinical hip screening and ultrasound examination. Early intervention is simple, painless and has a high recovery rate.
关键词
发育性髋关节发育不良 /
筛查 /
早期干预 /
婴儿
Key words
developmental dysplasia of the hip /
screening /
early intervention /
infants
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] Weinstein SL,Mubarak SJ,Wenger DR.Developmental hip dysplasia and dislocation:Part I[J].Instr Course Leet,2004,53:523-530.
[2] Davies SJ,Walker G.Problems in the early recognition of hip dysplasia[J].J Bone Joint Surg Br,1984,66(4):479-484.
[3] Graf R.The diagnosis of congenital hip-joint dislocation by the ultrasonic combound treatment[J].Arch Orthop Trauma Surg,1980,97(2):117-133.
[4] 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.
[5] Wynne-Davies R.Acetabular dysplasia and familial joint laxity:Two etiological factors in congenital dislocation of the hip.A review of 589 patients and their families[J].J Bone Joint Surg Br,1970,52(4):704-716.
[6] Dunn PM.Perinatal observations on the etiology of congenital dislocation of the hip[J].Clin Orthop Relat Res,1976, 119:11-22.
[7] Coleman SS.Congenital dysplasia of the hip in the Navajo infant[J].Clin Orthop Relat Res, 1968, 56:179-193.
[8] Jones D.Neonatal detection of developmental dysplasia of the hip(DDH)[J].J Bone Joint Surg Br,1998,80(6):943-945.
[9] Omeroglu H,Koparal S.The role of clinical examination and risk factors in the diagnosis of developmental dysplasia of the hip:a prospective study in 188 referred young infants[J].Arch Orthop Trauma Surg,2001,121(1-2):7-11.
[10] Chan A,McCaul KA,Cundy PJ, et a1.Perinatal risk factors for developmental dysplasia of the hip[J].Arch Dis Child Fetal Neonatal Ed,1997,76(2):94-100.
[11] Hummer CD,MacEwen GD.The coexistence of torticollis and congenital dysplasia of the hip[J].J Bone Joint Surg Am,1972,54(6):1255-1256.
[12] Ilfeld F,Westin G,Makin M.Developmental dislocation of the hip[J].Clin Orthop Relat Res, 1986, 203:276-281.
[13] Lehmann HP, Hinton R, Morello P, et al . Developmental dysplasia of the hip practice guideline: technical report. Committee on quality improvement, and subcommittee on developmental dysplasia of the hip[J]. Pediatrics, 2000,105(4):e57.
[14] 杨云霞.发育性髋关节脱位的诊断与治疗[J].中国民康医学,2010, 22(8):1029-1032.
[15] 宋亚梅. 发育性髋关节脱位的研究[J].中国伤残医学, 2010,18(6): 186-187.
[16] 李玉婵,陈博昌,张菁.超声检查在发育性髋关节异常中的应用[J].中国矫形外科杂志,2005,13(7):538-540.
PDF(572 KB)
