超声波在小婴儿髋关节脱位治疗中的监测作用

Monitoring of ultrasound screening for developmental dysplasia of the hip in infant

目的探讨髋关节超声波检查在小婴儿髋关节脱位治疗监测中的作用。方法2005年4月～2008年2月筛查疑似髋关节脱位小婴儿3220例,其中Ⅱc型以上类型为异常髋关节62例患儿,男性16例,女性46例;共89髋。在采用Pavlik吊带治疗中,用B超进行检测,根据超声波检查结果调整吊带位置。结果89个病髋中,Ⅱc型为47髋(0.73%),Ⅱd型为21髋(0.33%),Ⅲ型为16髋(0.25%),Ⅳ型为5髋(0.08%)。在Pavlik吊带治疗中,经B超监测,75髋吊带一次复位成功。调整Pavlik吊带5髋,3个Ⅲ型和1个Ⅳ型病髋经过调整后复位满意,另1个Ⅳ型病髋调整失败后改为麻醉下复位和石膏固定。随访4～38个月,平均18个月,失随访9髋,均为Ⅱc型。结论髋关节超声检查是一种安全、简便、有效的诊断方法,在小婴儿髋关节脱位治疗中起到监测作用。

Objective To assess the clinical efficacy and application of the ultrasound screening for developmental dysplasia of the hip in infants. Methods From April 2005 to February 2008,3 220 infants with suspected hip instability were enrolled. There were 89 positive sonographic hips in the 3 220 infants and the 89 hips were treated by Pavlik harness under sonographic monitoring. Results Pavlik harness treatment was performed in 89 hips,which were considered type Ⅱc（47）,Ⅱd（21）,Ⅲ（16）,Ⅳ（5）. After 18 months follow-up,75 hips achieved successful reduction under ultrasound supervision. Three type Ⅲ hips and one type Ⅳ hip achieved successful reduction after harness adjustment. One type Ⅳ hip failed reduction after harness adjustment and underwent close reduction and spica casting under general anesthesia. Conclusion The ultrasound screening for developmental dysplasia of the hip in infants is a safe and effective diagnostic method and plays a great role in supervision during the treatment.