超声在发育性髋脱位诊断中的应用研究

Value of ultrasonography in diagnosis of developmental dislocation of the hip

目的探讨婴幼儿髋关节的超声检查方法及对发育性髋脱位的诊断价值。方法应用超声检测123例婴幼儿246个髋关节，其中正常174髋，异常72髋，观察髋关节形态结构并测量相关参数指标（α角、β角、髋臼角、股骨头覆盖率）。结果①超声可以较客观清楚地显示髋关节形态结构、头臼位置关系；②婴幼儿髋关节的超声指标α角、β角、髋臼角、股骨头覆盖率的正常值分别为：65．06°±3．65°、39．90°±5．02°、25．99°±3．63°和（63．65±3．97）%，正常髋与异常髋间口角、p角、髋臼角、股骨头覆盖率比较差异均有统计学意义（P〈O．001）；③超声可依据a角、p角、髋臼角和股骨头覆盖率的异常及程度进行分型诊断，对正常髋（Ⅰ型）、半脱位髋（Ⅲ型）及全脱位髋（Ⅳ型）的诊断正确率均为100％，对发育不良髋（Ⅱ型）的诊断正确率为95％；④超声对股骨头骨化中心的显示较x线敏感（X^2=5．14，P〈0.05）。结论超声检查可作为婴幼儿发育性髋脱位的早期确诊手段及首选筛查方法。

Objective To study sonographic anatomy and ultrasonic scanning method of infant hip, and to evaluate the role of ultrasonography（US） in diagnosis of developmental dislocation of the hip（DDH）. Methods Two hundred and forty＇six hips of 123 infants were examined with US. Seventy-two hips with DDH were compared with 174 normal hips. The morphology and structure information of hips were observed,and correlative parameter index such as angle α, angle β, acetabular index（AI）, femoral head percentage of cover （FHC） were measured. Results ①Morphology and structure information of hips, position relation of femoral head and acetabulum were demonstrated by US impersonally and clearly. ②The normal values of infant hip＇s ultrasonic index such as angle a, angle β, AI, FHC were 65.06°± 3.65°, 39.90°± 5.02°, 25.99°± 3.63° and （63.65 ± 3.97） %, respectively. There were statistical significance between normal hip and DDH in angle α, angle β,AI and FHC（ P〈0. 001）. ③According to the ultrasonic index measurement of hip such as the angle a, angle β, AI, FHC, hip joint were divided 4 types by US. Diagnostic accuracy of US to normal hip,subluxation hip and dislocation hip were 100% ,and it was 95% to developmental dysplasia hip. ④It was more sensitive by US than by X ray in displaying the ossification center of the femoral head （ χ^2 = 5.14, P〈0.05）. Conclusions US could be an early definite and a preferred screening method in diagnosis of DDH.