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目的探讨超声检查在婴幼儿发育性髋关节发育不良的早期诊断及疗效评价。方法对临床疑为发育性髋关节发育不良1 074例婴幼儿中,确诊为DDH的109例婴幼儿单/双侧共116个髋关节,根据Graf分型采取不干预或Pavlik挽具治疗后复查,评估髋关节发育状况,并对两次测量值进行统计学对比分析。结果 (1)109例婴幼儿超声初诊结果:Ⅰ型髋关节102个(46.8%),Ⅱa型和Ⅱb型髋关节83个(38.1%),Ⅱc型髋关节12个(5.5%),D型髋关节9个(4.1%),Ⅲ型髋关节9个(4.1%),Ⅳ型髋关节3个(1.4%);(2)复查超声结果:对初诊为Ⅱa型和Ⅱb型髋关节未进行临床干预,其中64个髋关节转为Ⅰ型;对初诊Ⅱc、D、Ⅲ、Ⅳ型髋关节用Pavlik挽具治疗后复查,其中15个髋关节转为Ⅰ型,9个髋关节转为Ⅱb型,6个髋关节转为Ⅱc型,2个髋关节转为D型;(3)Ⅱa型和Ⅱb型、Ⅱc型髋关节两次α角度值有明显统计学意义,P值分别为0.026、0.043,而β角比较分析差异无明显统计学意义;其余Ⅰ、Ⅱc、D、Ⅲ、Ⅳ型髋关节α、β角比较分析差异均无明显统计学意义。结论超声能动态观察婴幼儿髋关节发育情况,并对临床疗效的评价提供可靠依据。
Objective To investigate the early diagnosis and therapeutic effect of ultrasound in the development of hip dysplasia in infants and young children. Methods One hundred and fourteen infants with 116 DDH diagnosed as DDH were enrolled in this study. Of the 1,074 infants with clinical suspicion of developmental dysplasia of the hip, a total of 116 hips with single / bilateral infants were diagnosed. According to Graf classification, no intervention or Pavlik harness , Assess the development of hip joint status, and the two measurements were statistically analyzed. Results (1) The results of ultrasonography in 109 infants and young children were 102 (46.8%) of type Ⅰ, 83 (38.1%) of type Ⅱa and Ⅱb, 12 (5.5%) of type Ⅱc, (4.1%) of hip joint, 9 (4.1%) of type Ⅲ hip joint and 3 (1.4%) of type Ⅳ hip joint. (2) The results of ultrasound examination were not performed for newly diagnosed type IIa and type IIb hip joint Clinical intervention, in which 64 hips to type Ⅰ; newly diagnosed Ⅱc, D, Ⅲ, Ⅳ type of hip with Pavlik harness after treatment review, of which 15 hip to type Ⅰ, 9 hip to Ⅱ b Type, 6 hips to Ⅱ c type, 2 hips to D type; (3) Ⅱ a and type Ⅱ b, Ⅱ c type hip joint angle α twice statistically significant, P values were 0.026, 0.043, while there was no significant difference in β angle between the two groups. There was no significant difference between the other groups in Ⅰ, Ⅱc, D, Ⅲ, Ⅳ hip joint α, β angle. Conclusion Ultrasound can dynamically observe the development of hip joint in infants and young children and provide a reliable basis for the evaluation of clinical efficacy.