南京市1～5岁儿童下肢发育与步态问题的调查及分析  

Investigation and analysis of lower limb development and gait in children aged 1～5 in Nanjing

作　　者：宋骏[1] 芮洪新 陈忆晴 解雅春[1] 童梅玲[1] 池霞[1,2] 张敏[1] SONG Jun;RUI Hong-xin;CHEN Yi-qing;XIE Ya-chun;TONG Mei-ling;CHI Xia;ZHANG Min(Department of Child Health Care, Maternity Hospital, Nanjing Medical University,Nanjing,Jiangsu 210004,China;Pediatric Research Institution, Nanjing Medical University, Nanjing,Jiangsu 210029,China)

机构地区：[1]南京医科大学附属妇产医院儿童保健科,江苏南京210004 [2]南京医科大学儿科医学研究所,江苏南京210029

出　　处：《中国儿童保健杂志》2018年第5期500-503,共4页Chinese Journal of Child Health Care

基　　金：中国疾病预防控制中心妇幼保健中心儿童早期发展适宜技术研究基金(2017FYE001)

摘　　要：目的分析1~5岁儿童下肢骨骼发育与步态问题之间的联系,为儿科临床医生诊断儿童步态问题、提出早期干预措施提供依据。方法随机选取2012年1月-2016年12月在南京市妇幼儿童保健门诊体检的741名1~5岁儿童进行步态分析,同时进行股四头肌角(Q角)、下肢踝距、下肢旋转成角的测量。结果 1)不同年龄组儿童间的Q角和踝距数值均差异存在统计学意义(F=51.28、11.27,P均<0.05)。2)1~5岁儿童随着年龄的增长Q角持续增大,至4岁时达到峰值,随后Q角值减小,且Q角这种随年龄的变化趋势无性别差异。3)当儿童存在生理性膝外翻、扁平足、双足旋前、足内旋这些下肢发育问题时,Q角和踝距的值都普遍偏大,且差异有统计学意义(P均<0.05)。结论 1~5岁儿童股四头肌角、下肢踝距存在动态变化过程,并呈现随年龄增长先增大后减小的规律;当1~5岁儿童存在生理性膝外翻、扁平足、双足旋前、足内旋这些下肢发育问题时,Q角和踝距的值都普遍偏大。Objective To analyze the relationship between skeletal development and gait problems of lower limbs in children aged 1～5 years,in order to provide pediatric clinicians with evidence for early diagnosis and intervention.Methods A total of 741 children were randomly selected from January 2012 to December 2016 in Nanjing Maternal and Child Health Care Outpatient. Gait, Q angle, lower extremity ankle distance,lower extremity rotation and lower limb angle were measured. Results 1）There were statistically significant differences in Q angle and ankle distance among children of different age groups（F=51.28、11.27,P〈0.05）. 2）Q angle continued to increase with age, reaching a peak at four years old, and then the Q angle decreased.There was no gender difference in Q angle trend between 1～5 years.3）In children with physiological knee valgus, flat feet, foot overpronation,foot pronation of these lower limb development problems,Q angle and ankle distance values were generally larger（P〈0.05）.Conclusions It is a dynamic change process in the change of 1 to 5-year-old children quadriceps muscle angle,lower extremity ankle distance,and it shows the first increase with age and then reduces the law ; Q angle and ankle distance values are too larger in children with physiological knee valgus,flat feet,foot overpronation,foot pronation of these lower limb gait problems.

关 键 词：儿童下肢骨骼发育 步态分析 Q角 踝距 生理性膝外翻 力线 过度旋前 

分 类 号：R179[医药卫生—妇幼卫生保健]