超声在小儿发育性髋关节异常筛查及吊带治疗中的应用  

Application of ultrasonography in screening and treatment of developmental hip joint abnormality in children

作　　者：董建党[1] 周玫娟[2] 陈雨娜[2] DONG Jiandang;ZHOU Meijuan;CHEN Yunna(Ultrasound Department of the First People's Hospital of Shangqiu City, Shangqiu Clinical College of Xuzhou Medical University, Shangqiu 476000, P.R.China;Image Teaching and Research Office of Shangqiu Medical College, Shangqiu 476100, P.R.China)

机构地区：[1]河南省商丘市第一人民医院徐州医科大学商丘临床学院超声科,河南商丘476000 [2]河南省商丘医学高等专科学校影像教研室,河南商丘476100

出　　处：《医学影像学杂志》2021年第1期95-99,共5页Journal of Medical Imaging

基　　金：河南省高等教育教学改革研究与实践项目(编号:2019SJGLX763);河南省教育厅高等学校青年骨干教师培养计划资助项目(编号:2018GGJS256)。

摘　　要：目的探讨超声筛查小儿发育性髋关节异常(DDH)和在吊带治疗疗效评估方面的应用价值。方法选取本院收治的DDH患儿68例为研究组,患儿初诊及吊带治疗后均行超声检查,另纳入同期疑似DDH经超声检查的正常小儿68例为对照组;对比初诊时2组骨顶角(α)、软骨顶角(β)的大小,统计研究组患儿的Graf分型结果,对比研究组吊带前后α、β角及左右股骨头内侧缘与耻骨联合中点间隔长度的差值(d),分析研究组患儿吊带的疗效情况。结果研究组患儿的α角比对照组小儿更小,β角则更大,差异有统计学意义(P<0.05);研究组68例患儿共计患髋75个,Ⅱa型22个、Ⅱb型30个、Ⅱc型9个、Ⅱd型12个Ⅲ和Ⅳ型各1个。与治疗前相比,研究组患儿吊带后α角明显变大,β角明显变小,d值也明显变小,差异有统计学意义(P<0.05)。研究组患儿经吊带治疗后,69个患髋转为Ⅰ型,治愈率为92%。结论超声不仅对小儿发育性髋关节异常筛查有重要作用,在经吊带治疗后患儿的随访监测中也有较高的临床意义。Objective To analyze the value of ultrasound screening for developmental dysplasia of hip(DDH)in children and to evaluate the efficacy of sling therapy.Methods We selected 68 DDH children admitted in our hospital from december 2017~december 2019 as the study group.All the children were examined by ultrasound after initial diagnosis and sling treatment,and 68 normal children suspected DDH ultrasound examination were included as the control group in the same period.We compared the size of bone apex angle(α)and cartilage apex angle(β)in the two groups at the time of initial diagnosis,compared the Graf classification results of the children in the study group,the difference between the anterior and posteriorα,βangles of the sling and the length of the midpoint interval between the medial margin of the left and right femoral head and the pubic joint(d),and analyzed the curative effect of the sling in the study group.Results Theαangle in the study group was smaller than that in the control group,and theβangle was larger(P<0.05).The study group had a total of 75 hip patients,22 in type II a,30 in type II b,9 in type II c,12 in type II,1 in type III and IV each.Theαangle was significantly larger,theβangle was significantly smaller,and the d value was also significantly smaller,the difference was statistically significant(P<0.05).69 patients with hip change to type I were treated with suspenders,with a cure rate of 92%.Conclusion Ultrasound not only plays an important role in the screening of developmental hip abnormalities in children,but also has high clinical significance in the follow-up monitoring of children after treatment with sling.

关 键 词：超声检查 患儿 发育性髋关节异常 吊带治疗 

分 类 号：R445.1[医药卫生—影像医学与核医学] R726.8[医药卫生—诊断学]