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目的通过与四川成都地区正常儿童手部X线片对比分析,了解四川阿坝州壤塘县地区儿童大骨节病发病情况及特点。方法选取4~16岁阿坝壤塘南木达乡异地育人学校学生与成都地区正常儿童对比分析。全部儿童进行双手X线摄片,X线片由来自四川省疾病预防控制中心、四川大学华西医院骨科、影像科、风湿免疫科及小儿外科共10人组成的阅片专家组共同判读。结果壤塘县儿童手部X线片显示锥形骨骺及异常改变多,14.6%的儿童出现食指、中指、环指近、中节多发、对称的异常改变,成都地区儿童未发现。结论说明在政府积极干预下,一方面壤塘县大骨节病表现非典型化,另一方面,其致病因子依然存在。探索大骨节病致病机理,寻求早预防,早诊断的方法,依然是我国骨科和地病学者需共同承担的责任。
Objective To compare and analyze the hand X-ray of normal children in Chengdu area of Sichuan province to find out the incidence and characteristics of Kashin-Beck disease in children in Rangtang County, Aba Prefecture, Sichuan Province. Methods A comparative study of students from 4 to 16 years old in Aba School of Aba County in Aba Suburban and normal children in Chengdu was conducted. All children underwent two-handed X-ray radiographs. The radiographs were read by a panel of reading experts composed of 10 persons from Sichuan Provincial Center for Disease Control and Prevention, West China Hospital of Sichuan University, Department of Orthopedics, Rheumatology and Pediatric Surgery. Results In Xintang County, children ’s hand X - rays showed conical epiphyseal and abnormal changes. 14.6% of children showed multiple epiphysis, middle finger and ring finger, multiple nodules and abnormal symmetry. Children in Chengdu were not found. The conclusion shows that with the active government intervention, on the one hand, the performance of Kashin-Beck disease in Rangtang County is atypical; on the other hand, the pathogenic factors still exist. To explore the pathogenic mechanism of Kashin-Beck disease, to seek early prevention and early diagnosis is still the responsibility shared by orthopedics and earthworm scholars in our country.