婴儿发育性髋关节发育不良的早期筛查及影响因素分析  

Early screening of infant developmental hip dysplasia and analysis of the influencing factors

作　　者：冯婷婷 赵旭飞[1] 徐静芳[2] 赵国强[1] FENG Ting-Tingy;ZHAO Xu-Fei;XU Jing-Fang(Department of Trauma Surgery,the Children's Hospital of Zhejiang University School of Medicine,Hangzhou,Zhejiang 310051,China)

机构地区：[1]浙江大学医学院附属儿童医院创伤外科,浙江杭州310051 [2]浙江大学医学院附属儿童医院骨科,浙江杭州310051

出　　处：《中国妇幼保健》2021年第19期4526-4529,共4页Maternal and Child Health Care of China

基　　金：浙江省基础公益研究计划项目(LY20H060001)。

摘　　要：目的分析婴儿发育性髋关节发育不良(DDH)的早期筛查结果,探讨其影响因素。方法选取2020年1月-2021年4月期间由社区医院疑诊为发育性髋关节发育不良的488例患儿,转诊至浙江大学医学院附属儿童医院,行专科髋关节临床检查、影像学检查和流行病学因素分析,对患儿临床资料进行单因素及多因素Logistic分析,探讨发育性髋关节发育不良的影响因素。结果 488例疑诊为DDH的患儿中经专科确诊的患儿有51例(10.45%,15/488)(63髋),其中男9例(12髋),女42例(51髋),男女比例1∶4.67,左侧41髋(65.08%),右侧22髋(34.92%),左右比例1.86∶1,其中单髋39例,双髋12例。多因素分析发现,女性患儿、臀位、皮纹不对称、有家族史、合并畸形、孕期羊水少、高龄产妇及襁褓捆绑为DDH发病的危险因素(P<0.05)。结论对婴儿采用初筛及专科检查的方式,可以早期发现和确诊DDH,并且发现DDH发病的危险因素包括女性患儿、臀位、皮纹不对称、有家族史、合并畸形、孕期羊水少、高龄产妇及襁褓捆绑。在早期初筛时,应格外留意具备上述危险因素的患儿,及时随访复查。Objective To analyze the early screening results of infant developmental dysplasia of the hip(DDH) in xx area and explore its influencing factors.Methods From January 2020 to April 2021, a total of 488 children suspected to be diagnosed with developmental hip dysplasia in community hospitals were selected and transferred to Children’s Hospital Affiliated to Zhejiang University School of Medicine.and underwent clinical examination, imaging examination and epidemiological factor analysis of the hip joint. Single-factor and multi-factor Logistic analysis was performed on the clinical data of children to explore the influencing factors of developmental hip dysplasia. Results Among the 488 children suspected to be DDH, 51 cases(10.45%, 15/488)(63 hips) were diagnosed by specialist examinations. 9 males(12 hips), 42 females(51 hips), male to female ratio 1∶4.67, 41 hips on the left side(65.08%), 22 hips on the right side(34.92%), the left-to-right ratio 1.86∶1, of which 39 were single hips Cases, 12 cases of double hips. Through multivariate analysis, it was found that female children, asymmetry of breech position and gluteal lines, family history, combined malformations, oligohydramnios during pregnancy, elderly women, and swaddling were the risk factors for the onset of DDH(P<0.05).Conclusion The initial screening and specialized examinations for infants and young children can detect and diagnose DDH early and find that the risk factors for the onset of DDH include female children, breech position, The skin grain is not symmetrical, family history, combined deformity, Lack of amniotic fluid during pregnancy, elder parturient and infants are tied up. In the early screening, special attention should be paid to children with the above-mentioned risk factors, and files should be established for review in time.

关 键 词：髋关节发育不良 婴幼儿 早期筛查 因素分析 

分 类 号：R681[医药卫生—骨科学]