髋关节造影在儿童发育性髋关节发育不良诊疗中的应用进展  

Application of hip arthrography in the diagnosis and treatment of developmental hip dysplasia in children

作　　者：王波 苏菲[2] 杨帅 庞浩田 杨亚婷 颉强 Wang Bo;Su Fei;Yang Shuai;Pang Haotian;Yang Yating;Jie Qiang(Xi'an Medical University,Xi'an 710021,China;Pediatric Orthopaedic Hospital,Honghui Hospital,Xi'an Jiaotong University,Xi'an 710054,China)

机构地区：[1]西安医学院,西安710021 [2]西安交通大学医学院附属红会医院儿童骨病医院,西安710054

出　　处：《中华骨科杂志》2024年第22期1496-1502,共7页Chinese Journal of Orthopaedics

基　　金：陕西省儿童骨骼畸形与损伤疾病临床医学研究中心(2024SF-LCZX-16);陕西省重点研发计划-重点产业链-社会发展领域(2021ZDLSF02-11)。

摘　　要：因儿童关节软骨尚未充分骨化,临床诊治儿童关节疾病与损伤时附近解剖结构的可视化是难点问题。关节造影是一种高效便捷且微创的技术,尤其对儿童髋关节可视化极为重要。目前造影技术在发育性髋关节发育不良(developmental dysplasia of the hip,DDH)术中被广泛使用,但相关研究多集中在关节造影功效方面,探索其在术中、术后的评估及预测作用。本文综述髋关节造影技术的概念、髋关节造影的入路选择、髋关节造影流程、造影剂的剂量和使用操作、造影剂的不良反应;使用髋关节造影技术评价闭合复位质量;使用髋关节造影技术预测闭合复位后髋臼的发育转归;使用髋关节造影技术在切开复位或截骨术中的应用;使用髋关节造影技术观察髋关节软组织形态;使用髋关节造影技术结合核磁观察髋臼盂唇解剖结构。分析髋关节造影用于DDH评估的研究结果,有助于提高股骨头和髋臼的匹配性及复位质量评价的准确性,筛选盂唇内翻等阻碍同心圆复位的因素,提升预测髋臼发育转归的能力,对精准选择DDH患儿早期及残余畸形手术干预时机有重要的指导意义。综述应用造影技术用于评估DDH闭合复位质量及预测复位后髋臼发育转归的研究,有利于对目前DDH的临床诊疗工作及研究方向提供参考。Due to the fact that the articular cartilage of children's joints has not yet been fully ossified,visualizing the adjacent anatomical structures during the clinical diagnosis and treatment of joint diseases and injuries in children is a challenging issue.Arthrography is an efficient,convenient,and minimally invasive technique,and is particularly crucial for the visualization of children's hip joints.Currently,arthrography technology is widely employed during surgeries for developmental dysplasia of the hip(DDH),and in recent years,numerous studies have concentrated on the efficacy of joint angiography,exploring its assessment and predictive roles during and after the operation.We review the overview of hip joint arthrography techniques,such as the concept of arthrography,the selection of access routes for hip joint arthrography,the process of hip joint arthrography,the dosage and operation of contrast agents,and the adverse reactions of contrast agents;the use of hip joint arthrography to evaluate the quality of closed reduction;the use of hip joint arthrography to predict the future development and outcome of the acetabulum after closed reduction;the use of hip joint arthrography in the study of open reduction or osteotomy;the use of hip joint arthrography to observe the morphology of soft tissues in the hip joint;the use of hip joint arthrography in combination with nuclear magnetic resonance to observe the anatomical structure of the acetabular labrum.Summarizing the research results of arthrography for evaluating the corresponding indicators of the hip joint helps improve the matching between the femoral head and the acetabulum and the accuracy of evaluating the quality of reduction,uncovers identifying factors such as labrum varus that hinder concentric reduction,enhances the ability to predict the development and outcome of the acetabulum,and has significant guiding significance for the precise selection of the timing of surgical intervention for early and residual deformities in children with DDH.Exploring

关 键 词：发育性髋关节发育不良 造影 髋臼发育 

分 类 号：R726.8[医药卫生—儿科]