高频超声筛查发育性髋关节发育不良及吊带治疗疗效评估中应用价值  

The application value of high-frequency ultrasound in screening developmental dysplasia of the hip and evaluating the efficacy of harness therapy

作　　者：孜万提·艾提拜尔江 ZIWANTI Aitibaerjiang(Department of Ultrasound,Beijing Children's Hospital Xinjiang Hospital,Urumqi,Xinjiang 830091,China)

机构地区：[1]北京儿童医院新疆医院<新疆维吾尔自治区儿童医院>超声科,新疆乌鲁木齐830091

出　　处：《影像研究与医学应用》2024年第10期29-33,共5页Journal of Imaging Research and Medical Applications

摘　　要：目的:探究高频超声在婴幼儿发育性髋关节发育不良(DDH)筛查及吊带治疗效果评价中的应用价值。方法:选取2021年1月—2023年12月在北京儿童医院新疆医院行高频超声筛查的发育性髋关节发育不良患儿作为研究对象。以Graf检查结果作为金标准,分析超声检查在筛查DDH中的应用价值,探讨超声检查诊断DDH的诊断效能,并比较Pavlik吊带治疗前后DDH患儿的超声参数[骨顶角(α)、软骨顶角(β)、骨性髋臼覆盖率]的差异以及不同Graf分型患儿的治愈率差异。结果:124例DDH患儿(共计223个患髋)中男婴50例,女婴74例,平均年龄(74.88±22.61)天,超声检查结果显示:Ⅱa型髋关节144个,Ⅱb型髋关节71个,Ⅱc型髋关节4个,D型髋关节2个,Ⅲ型髋关节2个;超声诊断DDH的灵敏度为98.7%,特异度为88.0%,阳性预测值为98.7%,阴性预测值为88.0%,准确率为97.6%,Kappa值=0.866,一致性良好;与治疗前相比,DDH组治疗后的α角、骨性髋臼覆盖率均升高,β角减小(P<0.05);不同Graf分型患儿的治愈率比较,差异有统计学意义(P<0.05);其中Ⅱa、Ⅱb型、Ⅱc型、D型患儿的治愈率均高于Ⅲ型患儿(P<0.05)。结论:超声在DDH患儿的筛查中,具备较高的灵敏度、特异度和准确率,并且可评估DDH患儿吊带治疗的疗效,可为临床中DDH患儿的诊疗提供参考。Objective To explore the application value of high-frequency ultrasound in the screening of developmental hip dysplasia(DDH)in infants and young children and the evaluation of the effect of harness therapy.Methods Selecting infants and young children with developmental hip dysplasia who underwent high-frequency ultrasound screening at Beijing Children's Hospital Xinjiang Hospital from January 2021 to December 2023 as the research subjects,Graf test results were used as the gold standard to analyze the application value of ultrasonography in the screening of DDH,to investigate the diagnostic efficacy of ultrasonography in the diagnosis of DHH,and compare differences in ultrasound parameters[bony parietal angle(α),cartilage parietal angle(β),bony acetabular coverage]before and after Pavlik harness treatment in children with DDH,and the cure rate of children with different Graf subtypes.Results A total of 124 cases of developmental dysplasia of the hip(DDH)were identified,affecting a total of 223 hips.This included 50 male infants and 74 female infants,with an average age of(74.88±22.61)days.The ultrasound examination revealed the following distribution:typeⅡa in 144 cases,typeⅡb in 71 cases,typeⅡc in 4 cases,type D in 2 cases,and typeⅢin 2 cases.The sensitivity and specificity for ultrasound diagnosis of DDH were found to be 98.7%and 88.0%,respectively,with positive predictive value at 98.7%,negative predictive value at 88.0%,and accuracy rate at 97.6%.A Kappa value=0.866,indicated good consistency between diagnoses.Theαangle increased significantly after treatment compared to before treatment(P<0.05),while bony acetabular coverage also showed an increase;on the other hand,theβangle decreased significantly after treatment(P<0.05).Statistically significant differences were observed among different Graf types regarding cure rates(P<0.05),with higher cure rates observed for typesⅡa,IIb,Ⅱc,and D compared to typeⅢ(P<0.05).Conclusion Ultrasound has high sensitivity,specificity,and accuracy in screening

关 键 词：小儿发育性髋关节发育不良 Pavlik吊带治疗 超声筛查 

分 类 号：R445.1[医药卫生—影像医学与核医学]