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目的探讨体格检查在发育性髋关节发育不良(DDH)筛查工作中作为诊断依据的可靠性。方法 2 118例就诊于北京儿童医院DDH筛查门诊的患儿纳入本研究,所有病例经过病史采集,体格检查以及影像学检查后做出确定诊断,分析体格检查、病史与DDH的关联,评估体格检查结果作为初筛转诊的依据是否可靠。结果 2 118例患儿中,年龄<6个月组DDH患儿126例,6个月~1岁组DDH患儿50例;>1岁组DDH患儿10例。体格检查最常见的为双下肢皮纹不对称,其次主要有双髋外展不对称、双髋外展受限、双下肢不等长、髋关节外展弹响。3个年龄组中,体格检查阳性与最终确诊DDH存在一致性(P<0.05)。结论体格检查结果作为DDH筛查工作的诊断依据是可靠的,但最终诊断需要根据患儿病史、体格检查、影像学检查结果综合判断。
Objective To investigate the reliability of physical examination as a diagnostic basis in the screening of dysplastic hip dysplasia (DDH). Method 2 118 children admitted to DDH screening clinic in Beijing Children’s Hospital were enrolled in this study. All cases were diagnosed after physical examination, physical examination and imaging examination, and physical examination, history and DDH were analyzed, Check the results as the basis for screening referrals are reliable. Results Among 118 cases of children with DDH, 126 children with DDH at 6 months, 50 DDH children at 6 months to 1 year old and 10 children with DDH at 1 year old. The most common physical examination for the lower extremity dermatoglyphics asymmetry, followed by the main double hip abduction asymmetry, double hip abduction limited length of both lower extremities, hip abduction snapping. Among the three age groups, there was consistency between physical examination positive and final diagnosis of DDH (P <0.05). Conclusion The results of physical examination as DDH screening diagnosis is reliable, but the final diagnosis needs to be based on the history of children, physical examination, imaging findings comprehensive judgment.