发育性髋关节发育不良儿童行Graf法联合Harcke法的价值  

Value of Graf Method Combined with Harcke Method for Children with Developmental Hip Dysplasia

作　　者：丁淳 虞菁 裴蕾[1] DING Chun;YU Jing;PEI Lei(Physical Examination Center,Nantong City Maternal and Child Health Hospital,Nantong,Jiangsu 226001)

机构地区：[1]南通市妇幼保健院体检中心,江苏南通226001

出　　处：《智慧健康》2023年第16期79-82,91,共5页Smart Healthcare

基　　金：南通市卫生和计划生育委员会科研课题项目《Graf法和Herck法超声评估Pavlik吊带治疗0~6个月发育性髋关节发育不良儿童疗效对比研究》(项目编号:QB2020008)。

摘　　要：目的探讨Graf法联合Harcke法在0~6个月发育性髋关节发育不良(DDH)儿童Pavlik吊带治疗中的效果。方法选取2020年1月-2021年1月来本院行Pavlik吊带治疗的DDH婴幼儿100例为研究对象,其中,男40例,女60例,以X线检查结果作为“金标准”,联合使用Graf法与Harcke法评估Pavlik吊带治疗0~6个月DDH儿童的效果,分析评估该方法的敏感性、特异性及准确性。结果100例6个月以内DDH患儿髋关节经Graf法测值分型为I型63个,Ⅱa^(+)型10个,Ⅱa^(-)型5个,Ⅱb型5个,Ⅱc型6个,D型7个,Ⅲ型2个,Ⅳ型2个;采取超声Graf法联合超声Harcke法检测Pavlik吊带治疗疗效的敏感度、准确度明显高于超声Graf法(P值均小于0.05),特异度比较无显著差异(P>0.05);对Graf法的检测结果与X射线的检测结果进行一致性分析,发现其Kappa值为0.695,表示一致性中等;对Graf法联合Harcke法的检测结果与X射线的检测结果进行一致性分析发现,其Kappa值为0.875,表示一致性良好;对Graf法的检测结果与Graf法联合Harcke法的检测结果进行一致性分析发现,其Kappa值为0.465,表示一致性一般。结论Graf法联合Harcke法能显著提高评估的敏感度和准确度,与X射线检测结果的一致性良好,在Pavlik吊带治疗疗效评估中具有较高应用价值。Objective To explore application value and evaluate effect of Graf method combined with Harcke method in Pavlik sling treatment of children with developmental hip dysplasia(DDH)at 0-6 months.Methods The paper chose 100 infants and young children with DDH with Pavlik sling treatment in our hospital from January 2020 to January 2021 as research objects,including 40 males and 60 females.With"gold standard"X-ray examination results,cuaritve effect of Pavlik sling treatment for children aged 0-6 months with DDH was evaluated with ultrasound Graf method combined with the ultrasound Hartke method.Sensitivity,specificity and accuracy of the evaluation method was analyzed.Results According to Graf method,hip joints of 100 children with DDH within 6 months were classified into 63 cases of types Ⅰ,10 cases of types Ⅱa^(+),5 cases of types Ⅱa^(-),5 cases of types IIb,6 cases of types Ⅱc,7 cases of types D,2 cases of typesⅢand 2 cases of typesⅣ.Sensitivity and accuracy of combination of ultrasound Graf method and ultrasound Harcke method in detecting effect of Pavlik sling treatment was significantly higher than ultrasound Graf method(P<0.05),with no significant difference in specificity(P>0.05).Consistency analysis between Graf method and X-ray detection results showed,Kappa value was 0.695,indicating moderate consistency;consistency analysis of Graf method combined with Harcke method and X-ray detection results showed,Kappa value was 0.875,indicating good consistency.Consistency analysis of Graf method and Graf method combined with Harcke method revealed Kappa value of 0.465,indicating average consistency.Conclusion Combination of Graf method and Harcke method can improve sensitivity and accuracy of evaluation significantly,with good consistency with X-ray detection results,which has high application value in evaluating effect of Pavlik sling treatment.

关 键 词：Graf法 Harcke法 Pavlik吊带治疗 发育性髋关节发育不良 疗效评估 

分 类 号：R726.8[医药卫生—儿科]