摘要
目的:分析不同月龄发育性髋关节发育不良婴幼儿髋关节超声测值的变化,评价超声在治疗监测中的价值。方法:选择2019年5月-2020年11月北京市昌平区医院儿科早教门诊接受髋关节超声检查的0~6个月婴幼儿903例(1806髋,左侧903髋,右侧903髋)作为研究对象,采用超声测量α、β角及股骨头直径值,按照Graf诊断标准分型,比较不同月龄婴幼儿髋关节分型构成;比较Ⅰ型(正常)与Ⅱ、Ⅲ型(DDH)婴幼儿髋关节α、β角、股骨头直径超声测值变化。Ⅱb以上分型婴幼儿均采用Pavlik吊带法治疗,并定期门诊超声复查,评价超声在治疗监测中的价值。结果:A组、B组、C组、D组、E组、F组Ⅰ型检出率分别为85.00%、81.68%、90.18%、99.41%、97.50%、100%;A组、B组、C组Ⅱa型检出率分别为15.00%、18.11%、9.82%;D组Ⅱb型检出率为2.50%;B组、D组Ⅱc型检出率分别为0.14%、0.59%;B组Ⅲ型检出率为0.07%。A组、B组、C组、D组、E组Ⅱ、Ⅲ型α角小于Ⅰ型,A组、B组、C组Ⅱ、Ⅲ型β角大于Ⅰ型,A组、B组Ⅱ、Ⅲ型股骨头直径值小于Ⅰ型,差异均有统计学意义(P<0.05)。137例Ⅱa型中103例定期复查,34例失访,其中29例4周超声复查转为Ⅰ型,74例8~12周超声复查转为Ⅰ型,治愈率为100%。1例Ⅱb型、2例Ⅱc型确诊后均接受Pavlik吊带治疗,8~12周超声复查均达I型;1例Ⅲ型确诊后接受Pavlik吊带治疗,20周超声复查达Ⅰ型,治愈率均为100%。结论:超声α角、β角是筛查6个月内髋关节发育不良婴幼儿骨关节畸形的重要指标,可早期诊断骨关节畸形,利于早治疗;同时超声在治疗过程中可定期监测,可根据监测结果调整治疗方案,以助提高疗效。
Objective:To analyze the changes of ultrasound measurements of the hip joint in infants with developmental dysplasia of the hip(DDH)at different months of age,and to evaluate the value of ultrasound in treatment monitoring.Method:From May 2019 to November 2020,903 infants(1806 hip joints,903 left hip joints,903 right hip joints)in 0-6 months who received hip joint ultrasound in examination Beijing Changping District Hospital pediatric early education clinics were selected as the research object,theα,βangle and femoral head diameter were measured by ultrasound,classified according to the Graf diagnostic criteria,and the composition of the hip joint of infants of different months was compared.The changes of hip jointα,βangle and femoral head diameter were compared between typeⅠ(normal)and typeⅡ,Ⅲ(DDH)infants with classificationⅡb and above were treated with Pavlik sling,and regular outpatient ultrasonography was reviewed to evaluate the value of ultrasonography in treatment monitoring.Result:The detection rates of typeⅠin group A,B,C,D,E and F were 85.00%,81.68%,90.18%,99.41%,97.50%and 100%respectively;the detection rates of typeⅡa were 15.00%,18.11%,and 9.82%,respectively;the detection rates of typeⅡb in group D were 2.50%;the detection rates of typeⅡc in groups B and D were 0.14%and 0.59%,respectively;the typeⅢin groups B was 0.07%.In group A,group B,group C,group D,group E typeⅡ,Ⅲinfants withαangle smaller than typeⅠ.In group A,B,C,Ⅱ,Ⅲinfantsβangle greater than typeⅠ.In group A,B,the diameter of the femoral head of infants with typeⅡandⅢwere smaller than those of typeⅠ.The differences were statistically significant(P<0.05).Among the 137 infants with typeⅡa,103 were regularly reexamined,and 34 were lost to follow-up.Among them,29 were converted to typeⅠby ultrasound at 4 weeks,and 74 were converted to type I by ultrasound at 8-12 weeks,the cure rate was 100%.One infant with typeⅡb and 2 infants with typeⅡc received Pavlik sling after diagnosis,and all reached type
作者
王淳
史歆然
崔远光
WANG Chun;SHI Xinran;CUI Yuanguang(Beijing Changping District Hospital,Beijing 102200,China;不详)
出处
《中外医学研究》
2022年第13期66-70,共5页
CHINESE AND FOREIGN MEDICAL RESEARCH
关键词
婴幼儿
髋关节发育不良
超声测值
诊断
监测
Infants
Hip dysplasia
Ultrasound measurements
Diagnosis
Monitoring
