儿童髋关节暂时性滑膜炎复发的危险因素分析  

Risk factors for recurrence of transient synovitis of the hip in children

作　　者：王怀铿 黄少敏 吴海艺 裴新红 Wang Huaikeng;Huang Shaomin;Wu Haiyi;Pei Xinhong(Department of Orthopedics,Xiamen Children's Hospital,Xiamen 361000,China;Department of Nursing,Xiamen Children's Hospital,Xiamen 361000,China;Department of Orthopedics,Children's Hospital of Fudan University,Shanghai 201100,China)

机构地区：[1]厦门市儿童医院骨科,厦门361000 [2]厦门市儿童医院护理部,厦门361000 [3]复旦大学附属儿科医院骨科,上海201100

出　　处：《临床小儿外科杂志》2023年第9期861-865,共5页Journal of Clinical Pediatric Surgery

基　　金：厦门市医疗卫生指导性项目(35022202142D1246);厦门市儿童医院青年科研项目(CHP-2019-YRF-0024)

摘　　要：目的探讨儿童髋关节暂时性滑膜炎(transient synovitis,TS)复发的危险因素。方法回顾性分析厦门市儿童医院2017年1月至2020年1月收治的158例TS患儿临床资料,按TS是否复发分为复发组(16例)与未复发组(142例)。比较两组患儿的年龄、性别、发病侧别、入院前症状持续时间、颈前间隙及积液厚度、口服布洛芬人数比例以及炎性指标(白细胞、C反应蛋白、血沉)异常率的差异,采用Logistic回归分析TS复发的危险因素。结果复发组患儿双侧同时发病的比例(9/16,56.25%)高于未复发组(36/142,25.35%),差异有统计学意义(P=0.021);复发组比未复发组年龄[(5.63±2.12)岁比(5.50±2.33)岁]、性别(男/女:11/5比101/41)、入院前症状持续时间[(3.32±2.41)d比(4.62±5.03)d)]、积液厚度[(0.48±0.11)cm比(0.46±0.18)cm)]及颈前间隙厚度[(1.00±0.12)cm比(0.99±0.26)cm)]、口服布洛芬(6/16比55/142)、炎性指标异常率(白细胞升高:2/16比20/142,C反应蛋白升高:1/16比11/142,血沉升高:6/16比43/142)差异均无统计学意义(P>0.05)。Logistic回归分析结果显示,双侧同时发病(OR=3.72,P=0.017)是TS复发的独立危险因素,而年龄、性别、入院前症状持续时间、颈前间隙厚度、积液厚度以及血沉与TS的复发无关(P>0.05)。结论双髋同时发病是TS患儿复发的独立危险因素。Objective To explore the risk factors for recurrence of transient synovitis(TS)of the hip in children.Methods From January 2017 to January 2020,clinical data were retrospectively reviewed for 158 hospitalized children with transient synovitis of the hip.They were assigned into two groups of recurrent and non-recurrent according to whether TS recurred or not.The inter-group differences in age,gender,inilateral/bilateral,onset time,thickness of anterior cervical space,effusion,oral ibuprofen or not,abnormal rate of inflammatory parameters(white blood cell,C-reactive protein&erythrocyte sedimentation rate)were compared.Multivariate Logistic regression analysis was utilized for determining the risk factors of TS recurrence.Results The rate of bilateral simultaneous onset was much higher in recurrent group than that in non-recurrent group[(9/16,56.25%)vs.(36/142,25.35%)].And the difference was statistically significant(P=0.021).No significant inter-group differences existed in age(5.63±2.12 vs.5.50±2.33 years),gender(male/female,11/5 vs.101/41),onset time(3.32±2.41 vs.4.62±5.03 day),thickness of anterior cervical space(1.00±0.12 vs.0.99±0.26 cm),effusion(0.48±0.11 vs.0.46±0.18 cm),oral ibuprofen or not(6/16,37.50%vs.55/142,38.73%),abnormal rate of inflammatory parameters(leukocytosis 2/16,12.50%vs.20/142,14.08%,elevated C-reactive protein 1/16,6.25%vs.11/142,7.75%,elevated sedimentation rate(6/16,37.50%vs.43/142,30.28%)(P>0.05).Logistic regression analysis revealed that bilateral simultaneous onset(OR=3.72,P=0.017)was an independent risk factor of TS recurrence.Age,gender,onset time,thickness of anterior cervical space,effusion and erythrocyte sedimentation rate were not correlated with recurrence of TS(P>0.05).Conclusion Children with a simultaneous onset of TS are more likely to relapse.

关 键 词：髋关节 滑膜炎 影响因素分析 外科手术 儿童 

分 类 号：R726.8[医药卫生—儿科]