新生儿先天性骨骼肌肉畸形筛查结果及相关因素分析  

Analysis on screening results and related factors of neonatal congenital musculoskeletal abnormalities

作　　者：熊竹[1] 周龙龙[2] 唐盛平[1] XIONG Zhu;ZHOU Long-Long;TANG Sheng-Ping(The First Department of Orthopedics,Shenzhen Children＇s Hospital,Shenzhen,Guangdong 518038,China)

机构地区：[1]深圳市儿童医院骨一科,广东深圳518038 [2]遵义医学院珠海校区,广东珠海519041

出　　处：《中国妇幼保健》2018年第16期3743-3746,共4页Maternal and Child Health Care of China

基　　金：广东省深圳市知识创新计划项目(JCYJ20130401114111461)

摘　　要：目的探讨新生儿先天性骨骼肌肉畸形(CMD)筛查结果及相关因素,为尝试建立CMD的筛查模式及指导临床诊断提供参考依据。方法采用小儿矫形外科临床检查方法,筛查了2013年10月-2014年5月北京大学深圳医院和深圳市妇幼保健院2 564例出生1 d的新生儿,疑似存在CMD的患儿(颈部包块、外展试验或Ortolani试验阳性)通过超声协助诊断,记录所有体检及超声结果,并统计CMD发病率,SPSS 21.0软件对结果进行统计学分析。结果 2 564例新生儿中,体格检查检出存在CMD共63例(2.46%):髋关节半脱位4例(0.16%),髋关节发育不良47例(1.83%),马蹄内翻足畸形2例(0.08%),多指畸形9例(0.35%),并指畸形1例(0.04%);Logistics回归分析显示:性别(OR=3.03,95%CI=1.141~8.057,P=0.026)和分娩方式(OR=2.49,95%CI=1.003~6.184,P=0.049)是髋关节发育异常的风险因素。结论体格检查及超声是非常安全有效的筛查方法,如果规范CMD筛查方法和流程,有助于疾病的早期识别和及时治疗,从而改善预后,提高人口健康水平。Objective To explore the screening results and related factors of neonatal congenital musculoskeletal abnormalities,provide a reference basis for establishment of screening pattern and guidance of clinical diagnosis of neonatal congenital musculoskeletal abnormalities. Methods A total of 2 564 one-day neonates born in Shenzhen Hospital of Peking Hospital and Shenzhen Maternal and Child Health Care Hospital were screened by clinical physical examination. The neonates suspected of congenital musculoskeletal abnormalities（ neck mass,positive result of abduction test or Ortolani test） were diagnosed by ultrasonography. The results of physical examination and ultrasonograpy were recorded. The incidence rates of congenital musculoskeletal abnormalities were analyzed statistically. SPSS 21. 0 software was used for statistical analysis. Results Among 2 564 neonates,63 neonates（ 2. 46%） were found with congenital musculoskeletal abnormalities during physical examination,including 4 neonates（ 0. 16%） with hip subluxation,47 neonates（ 1. 83%） with hip dysplasia,2 neonates（ 0. 08%） with talipes equinovarus,9 neonates（ 0. 35%） with polydactyly,and 1 neonate（ 0. 04%） with syndactyly. Logistic regression analysis showed that gender（ OR = 3. 03,95% CI = 1. 141-8. 057,P = 0. 026） and delivery mode（ OR = 2. 49,95% CI = 1. 003-6. 184,P = 0. 049） were risk factors of hip dysplasia. Conclusion Physical examination and ultrasonography are effective and safe screening methods. Standardized screening methods and process of congenital musculoskeletal abnormalities are helpful to early detection and timely treatment of the diseases,which can improve prognosis and improve healthy level of population.

关 键 词：新生儿 先天性骨骼肌肉畸形 筛查模式 相关因素 

分 类 号：R174[医药卫生—妇幼卫生保健] R726.2[医药卫生—公共卫生与预防医学]