婴儿发育性髋关节发育不良超声筛查情况及影响因素分析  

Ultrasound screening of developmental dysplasia of the hip in infants and analysis of its influencing factors

作　　者：杨茜 石影 张永花[1] 郑华 张婧洁[1] 刘艳敏[1] Yang Qian;Shi Ying;Zhang Yonghua;Zheng Hua;Zhang Jingjie;Liu Yanmin(Department of Child Health Care,Lanzhou Maternal and Child Health Care Hospital,Lanzhou 730030,China;Department of Ultrasound,Lanzhou Maternal and Child Health Care Hospital,Lanzhou 730030,China)

机构地区：[1]兰州市妇幼保健院儿童保健科,甘肃兰州730030 [2]兰州市妇幼保健院超声科,甘肃兰州730030

出　　处：《兰州大学学报（医学版）》2024年第7期37-42,共6页Journal of Lanzhou University（Medical Sciences）

基　　金：兰州市科技计划项目(2021-1-123,2022-2-108);兰州市卫生健康行业科研项目(A2023024)。

摘　　要：目的通过探究发育性髋关节发育不良的相关因素,为其早期预测及三级预防提供依据,降低其发病率。方法选取2021年3月—2023年3月在兰州市妇幼保健院儿童保健科体检的1107例3月龄婴儿为研究对象,记录髋关节外部形态、发育情况及运动状态,超声检查并采用Graf法标准分型评估髋关节发育情况。同时通过问卷调查可能影响髋关节发育的因素,采用多因素Logistic回归分析发育性髋关节发育不良发病的影响因素。结果1107个左髋中,异常的有75个(6.8%);1107个右髋中,异常的有53个(4.8%),差异有统计学意义(P<0.05)。母亲文化程度高、胎次增加、孕期补钙、孕期补充维生素D、做运动操是发育性髋关节发育不良发病的保护因素,臀位、冬季出生、女性、双下肢包裹为发育性髋关节发育不良发病的危险因素。结论发育性髋关节发育不良发病有型别、侧别特征,髋关节不稳定(Ⅱb型)为常见类型,左侧多于右侧。母亲孕期补充钙和维生素D,婴儿增加髋关节外展操锻炼,可以减少发育性髋关节发育不良的发生。Objective To take early prediction of the occurrence of developmental dysplasia of the hip and provide a basis for its tertiary prevention by exploring the relevant factors affecting its development,in order to reduce its incidence.Methods From March 2021 to March 2023,1107 three-month-old infants who underwent physical examinations at the Department of Child Health at Lanzhou Maternal and Child Health Hospital were selected as the study subjects.The external morphology,developmental status and motor status of the hip joints were recorded.Ultrasonographic examinations were performed,and the Graf classification used to evaluate the development of the hip joints.The factors that might have affected the development of the hip joint were also investigated via questionnaires to analyze the factors related to developmental dysplasia of the hip by multifactor logistic regression analysis.Results 75(6.8%)of 1107 left hips were abnormal.53(4.8%)of 1107 right hips were abnormal.The differences were statistically significant(P<0.05).High maternal literacy,increased gestational age,calcium supplementation during pregnancy,vitamin D supplementation during pregnancy,and regular exercise were protective factors for the development of developmental dysplasia of the hip, and breech position, winter birth, female gender and double lower limb wrapping were risk factors.Conclusions Characteristics of type and side in the development of developmental dysplasia of thehip, hip instability (type Ⅱb) was the most common, and the left side was more common than theright side. Calcium and vitamin D supplementation during pregnancy in mothers and increased hip abductionexercise in infants, and increased dissemination related knowledge, can reduce the incidence of developmentaldysplasia of the hip.

关 键 词：发育性髋关节发育不良 Graf法 超声筛查 影响因素 

分 类 号：R684.2[医药卫生—骨科学]