GrafⅡa(-)型髋关节发育不良早期干预效果的临床研究  

Clinical study on the effect of early intervention on Graf type Ⅱa(-) hip dysplasia

作　　者：陈智博[1] 王加宽[1] 王玉欢[1] 李俊[1] 盛春勇[1] 管文燕[1] Chen Zhibo;Wang Jiakuan;Wang Yuhuan;Li Jun;Sheng Chunyong;Guan Wenyan(Department of Pediatric Orthopedics,Yangzhou Maternal&Children's Healthcare Center,Affiliated Hospital,Medical College of Yangzhou University,Yangzhou 225002,China)

机构地区：[1]扬州市妇幼保健院,扬州大学医学院附属医院小儿骨科,225002

出　　处：《中华小儿外科杂志》2021年第9期818-822,共5页Chinese Journal of Pediatric Surgery

基　　金：江苏省妇幼健康科研项目(F201633);扬州市社会发展-重大科技示范项目(YZ2017065);扬州市十三五科教强卫领军人才(创新团队)(LJRC201823)。

摘　　要：目的探讨GrafⅡa(-)型髋关节发育不良患儿早期干预的效果。方法前瞻性分析2016年3月至2019年11月在扬州市妇幼保健院行髋关节超声筛查中发现的42至47日龄GrafⅡa(-)型髋关节发育不良患儿的临床资料,共58例60髋。按早期干预方法的不同,将患儿分为观察组(n=31例32髋)和干预组(n=27例28髋),观察组予以指导蛙式抱、髋关节外展活动等家庭干预措施,干预组行Pavlik吊带治疗。根据3月龄时髋关节超声检查结果,对比分析两组髋关节α角、α角增加值、β角、β角减少值及发育转归差异。结果3月龄时干预组髋关节α角为(63.14±2.86)°,观察组髋关节α角为(61.75±3.30)°,干预组较观察组大,差异无统计学意义(P>0.05);干预组髋关节β角为(59.25±4.72)°,观察组髋关节β角为(59.73±5.42)°,差异无统计学意义(P>0.05);干预组髋关节α角增加值为(10.79±2.75)°,观察组髋关节α角增加值为(8.44±3.43)°,干预组较观察组大,且差异有统计学意义(P<0.05);干预组髋关节β角减少值为(5.61±6.98)°,观察组髋关节β角减少值为(5.69±8.66)°,两组间差异无统计学意义(P>0.05)。3月龄时干预组25髋发育为成熟髋关节,3髋未成熟;观察组27髋发育为成熟髋关节,5髋未成熟,两组间差异无统计学意义(P>0.05)。干预组22髋显著好转,剩余6髋好转;观察组15髋显著好转,14髋好转,3髋无改善;两组均无恶化,组间差异有统计学意义(P<0.05)。结论使用Pavlik吊带作为GrafⅡa(-)型髋关节发育不良的早期干预方法有效。Objective To explore the efficacy of early intervention for Graf typeⅡa(-)hip dysplasia.Methods From March 2016 to November 2019,clinical data were prospectively reviewed for 58 children(60 hips)with Graf typeⅡa(-)hip dysplasia aged 42 to 47 days during hip ultrasound screening.According to different early interventions,they were divided into two groups of observation(n=31,32 hips)and intervention(n=27,28 hips).The observation group was subjected to such family intervention measures as frog holding and hip abductions.The intervention group was treated with Pavlik harness.According to the results of hip ultrasound at an age of 3 months,the differences ofαangle,increment ofαangle,βangle,decrement ofβangle and development outcomes were compared between two groups.Results At an age of 3 months,αangle of hip joint was(63.14±2.86)°in intervention group and(61.75±3.30)°in observation group and inter-group difference was not statistically significant(P>0.05);βangle of hip joint was(59.25±4.72)°in intervention group and(59.73±5.42)°in observation group and inter-group difference was not statistically significant(P>0.05);increment of hip jointαangle was(10.79±2.75)°in intervention group and(8.44±3.43)°in observation and inter-group difference was statistically significant(P<0.05);decrement ofβangle was(5.61±6.98)°in intervention group and(5.69±8.66)°in observation group and inter-group difference was not statistically significant(P>0.05).At an age of 3 months,25 hips matured in intervention group and the remaining 3 hips stayed immature.In observation group,27 hips matured and 5 hips remained immature.There was no significant inter-group difference(P>0.05).In intervention group,22 hips improved markedly and another 6 hips improved.In observation group,15 hips improved markedly,14 hips improved a little and 3 hips showed no improvement.There was no deterioration of hip joint in neither groups.There was significant inter-group difference(P<0.05).Conclusions Pavlik harness is effective for early in

关 键 词：髋关节 干预研究 支具 超声检查 

分 类 号：R726.8[医药卫生—儿科]