西藏日喀则地区发育性髋关节发育不良致病危险因素相关性研究  

Pathogenic risk factors correlation study of developmental dysplasia hip in Shigatse of Tibet

作　　者：杨晓东 莫小联 冯祥 赵利华[2] 应灏[2] 

机构地区：[1]西藏自治区日喀则市人民医院骨科,日喀则市发育性髋关节发育不良诊疗中心,日喀则857000 [2]上海交通大学附属儿童医院骨科,200062

出　　处：《中华实用儿科临床杂志》2016年第11期833-835,共3页Chinese Journal of Applied Clinical Pediatrics

基　　金：国家自然科学基金青年项目（81401763）;上海市自然科学基金国内科技合作资助项目（14695841100）;西藏自治区科技厅重点研发计划项目（2015XZ01G18）

摘　　要：目的开展西藏日喀则地区发育性髋关节发育不良（DDH）患者的流行病学调查，探讨DDH患病与海拔高度、婴儿包裹方式等危险因素的相关性，明确DDH在不同地域环境条件下的差异性，从而为制定地方针对性的干预措施、降低致残率提供参考依据。方法2013年6月至2014年6月随机抽样调查西藏Et喀则不同海拔地区5900例0～14岁的无症状世居藏族儿童，以SPSS18．0统计软件分析DDH发病与居住地海拔、生产生活方式、双下肢捆绑方式、分娩情况、遗传等因素的相关性。结果筛查出191例DDH病例，西藏日喀则地区DDH平均患病率约为32．4％0，单侧高于双侧，右侧33例，左侧68例，右侧：左侧=1．00：2．06。Pearson相关性分析结果显示DDH患病率与居住地海拔存在相关性（r=0．820，P=0．046）；Spearman相关性分析结果显示与生产生活方式存在相关性（r=0．530，P=0．048）；X^2检验分析显示与双下肢捆绑方式、臀位产亦均有相关性（P=0．0017、0．0082）。结论西藏高海拔地区儿童DDH患病具有一定的地域特点，与平原地区的同类疾病人群具有一定的差异性；居住地海拔高度、双下肢捆绑式包裹、游牧生活方式、臀位产等环境危险因素与地方的DDH发生有明显关联性，尤其是双下肢捆绑式包裹是当地主要的环境危险因素。Objective To perform the epidemiological analysis of the developmental dysplasia hip （DDH） in Shigatse of Tibet in order to explore the correlation between the onset of DDH with some risk factors such as altitude and take targeted intervention measures to reduce the disability rate of DDH. Methods A total of 5 900 children aged 0 to 14 year - old from different altitudes in Shigatse of Tibet were surveyed randomly from June 2013 to June 2014. SPSS 18.0 statistical software was used to analyze the correlation of the onset of DDH with residence altitude, produc- tion and living ways, binding method of the lower limbs, delivery situation and genetic factor. Results One hundred and ninety - one DDH cases were screened out, and the average incidence of DDH in Shigatse of Tibet was about 32.4%o,and unilateral was higher than bilateral,right side（33 cases） ： left side（68 cases） = 1.00 ： 2.06. The result of Pearson correlation analysis of the onset of DDH with residence altitude showed that there was significant correlation （ r = 0. 820, P = 0. 046）. The result of Spearman correlation analysis of the onset of DDH with production and living ways showed that there was significant correlation（ r = 0. 530 ,P = 0. 048）. The result of x^2 test analysis of the onset of DDH with binding method of the double lower limbs and breech delivery showed that there was statistical significance （P = 0.001 7,0. 008 2）. Conclusions The DDH incidence of children living in high altitude areas in Tibet has certain regional characteristics indicating that it has clear correlation with some environmental risk factors such as altitude, methods of the lower limbs binding, production and living ways and breech delivery, especially the bundled package of lower limbs is the main environmental risk factor of DDH.

关 键 词：西藏 儿童 发育性髋关节发育不良 致病危险因素 相关性研究 

分 类 号：R726.8[医药卫生—儿科]