533例超声筛查婴幼儿发育性髋关节发育不良结果及治疗随访分析  

Analysis of results and treatment of 533 cases of developmental hip dysplasia in infants screened by ultrasound

作　　者：杨坡[1] 栗河舟[1] 王新霞[1] 刘云[1] 王超华[1] 张兴鹤 YANG Po;LI He-zhou;WANG Xin-xia;LIU Yun;WANG Chao-hua;ZHANG Xing-he(Department of Ultrasound,the Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第三附属医院超声科,河南郑州450052

出　　处：《中国临床医学影像杂志》2020年第4期285-287,292,共4页Journal of China Clinic Medical Imaging

基　　金：河南省科技厅重点研发与推广专项(182102311200)。

摘　　要：目的:分析533例超声筛查婴幼儿发育性髋关节发育不良(Developmental dysplasia of hip,DDH)的结果,随访治疗效果,为临床治疗提供依据。方法:回顾分析2012年5月—2017年6月我院临床疑似DDH患儿共21281例,通过观察上述病例的超声检查结果中髋臼形态及α、β角测量值,应用Graf法对髋关节发育情况进行分型,统计DDH的分布情况,并随访治疗效果。结果:临床疑似DDH 21281例患儿(42562髋)中,DDH检查阳性率为2.50%(533/21281),DDH患儿中,女婴413例,男婴120例;双侧DDH患儿95例(190髋);左侧DDH 457例,右侧DDH 171例。176例DDH患儿接受髋关节外展操锻炼,164例恢复正常。115例DDH患儿接受Pavlik吊带治疗,104例恢复正常。5例接受闭合复位后石膏固定术,全部恢复正常。结论:DDH患儿女婴多于男婴,单侧多发,左侧较右侧明显多发。临床疑似DDH患儿检查阳性率约2.50%。髋关节外展操锻炼是Ⅱ型髋关节保守治疗的首选方式,尤其是Ⅱa型髋关节。Pavlik吊带治疗是DDH患儿保守治疗的首选方式。闭合复位后石膏固定术对于月龄较大、髋关节外展操锻炼和Pavlik吊带治疗失败的患儿尤其适用。Objective:To analyze the results of 533 cases of infant developmental dysplasia of hip(DDH)screened by ultrasound,and to follow up the therapeutic effect,so as to provide the basis for clinical treatment.Methods:From May 2012 to June 2017,a total of 21281 cases of suspected DDH in our hospital were analyzed retrospectively.The acetabulum shape and measurement values ofα,βangle in the ultrasonic examination results of the above cases were observed.Graf method was used to classify the development of the hip joint,and the distribution of DDH was analyzed,and the treatment effect was followed up.Results:Among 21281(42562 hips)cases of suspected DDH,the positive rate of DDH examination was 2.50%(533/21281).Among the DDH children,there were 413 female infants and 120 male infants.There were 95 cases of bilateral DDH(190 hips).Four hundreds and fifty-seven cases of DDH on the left and 171 cases of DDH on the right.One hundred and seventy-six DDH children received hip abduction exercise,and 164 returned to normal.One hundred and fifteen DDH children received Pavlik sling treatment,104 returned to normal.Five patients received gypsum fixation after closed reduction,and all returned to normal.Conclusion:There are more female infants than male infants in DDH,more on one side and more on the left side than on the right side.The positive rate of clinically suspected DDH is about 2.5%.Hip abduction exercise is the preferred conservative treatment for typeⅡhip joint,especially for typeⅡa hip joint.Pavlik sling is the first choice of conservative treatment for DDH children.Gypsum fixation after closed reduction is especially suitable for children who are older than one month old,who have failed in the treatment of hip extension exercise and Pavlik sling.

关 键 词：髋脱位 先天性 超声检查 

分 类 号：R726.8[医药卫生—儿科] R445.1[医药卫生—临床医学]