髋关节超声筛查在脑瘫高危儿随访中的临床价值

The Clinical Value of Hip Ultrasound Screening in High Risk Infants with Cerebral Paralysis

目的探讨超声波筛查发育性髋关节异常(DDH)在脑瘫高危儿随访中的临床价值,并进一步探讨脑瘫高危儿DDH的病因。方法选择2009年7月至2010年7月年龄小于6月的在院行康复治疗的未失访的脑瘫高危儿98例,其中男性58例,女性40例,全部进行髋关节超声波筛查(采用Graf静态检查法),对筛查异常者进行临床干预,1～2岁进行门诊随访,并对结果进行分析。结果 98例脑瘫高危儿中髋关节发育异常者40例,其中髋关节不稳定者18例,DDH22例(髋关节发育不良者12例,髋关节半脱位者3例,髋关节脱位者7例),对髋关节发育异常者进行临床早期干预,1～2岁门诊随访,仅1例股骨头复位不佳,所有病例均未发生股骨头缺血性坏死。结论脑瘫高危儿发生DDH的概率较正常儿增高,髋关节超声检查是一种安全、简便、有效的检查方法,对脑瘫高危儿伴发DDH的早期诊断和早期治疗有重要的临床意义。

Objective To study the clinical value of ultrasound screening for developmental dysplasia of the hip（DDH） in high risk infants with cerebral paralysis followed up,and further to explore the etiology of DDH of the high risk infants with cerebral paralysis.Methods To select high risk infants with cerebral paralysis 98 cases of rehabilitation treatment in Xuzhou children’s hospital and were not lost from 2009 July to 2010 July,who were aged less than 6 months,including 58 male cases,40 female cases,and all of their hips were screened with ultrasound（using static Graf inspection）,the abnormal were given clinical intervention,1-2 years old for outpatient follow-up,the results were analyzed.Results There were 40 abnormal cases in 98 cases of high risk infants with cerebral paralysis,the hip joint instability 18 cases,DDH 22 cases（developmental dysplasia of the hip 12 cases,subluxation of the hip 3 cases,hip dislocation 7 cases）,to carry on early clinically intervention with hip dysplasia,1 or 2 years later,only 1 case of femoral detorsion is poor,none of them have ischemic necrosis of femoral head.Conclusion The probability of the high risk infants with cerebral paralysis increased than normal infants.Hip ultrasound is a safe,simple,effective screening method for high risk infants with cerebral paralysis,early diagnosis and early treatment of DDH has important clinical significance.