超声筛查发育性髋关节异常高危因素小婴儿2100例

Ultrasound screening for developmental dysplasia of the hip in 2100 infants

目的探讨Graf髋关节超声诊断技术在小婴儿发育性髋关节异常(DDH)的应用意义,评价DDH高危因素小婴儿的髋关节发育状况。方法对2100例出生42d^5个月,临床提示有臀纹或大腿纹不对称,下肢长度差异,髋外展受限及其他具有DDH高危因素的婴儿进行超声检查,采用Graf静态超声波髋关节检查方法和标准型分类的标准对所有筛查结果进行统计和分析。结果 4200个受检髋关节中Ⅰ型髋关节3738个,占89%(3738/4200),其中Ⅰa型1566个,Ⅰb型2172个;Ⅱ型髋关节455个,占10.83%(455/4200),其中Ⅱa型240个,Ⅱb型156个,Ⅱc型48个,Ⅱd型11个;Ⅲ型髋关节5个,占0.12%(5/4200);Ⅳ型髋关节2个,占0.05%(2/4200)。结论超声检查能对小婴儿髋关节发育状况进行准确的定性和定量评估,是小婴儿早期诊断DDH的首选方法,为早期治疗提供重要参考依据。

Objective To explore the role of Graf＇s technique of ultrasound evaluation for developmental dysplasia of hips （DDH） in infants and assess the development of hip joints among neonates at high risk of DDH. Methods Using Graf＇s technique, static ultrasound was performed for 2100 infants （aged 24 days to five months） who were clinically found to be with asymmetrical hip/thigh folds, different length of limbs, limitation of abduction of the hip joint, and other risk factors. All the screening results were analyzed. Results Of these 4200 hip joints, 3738 （89%） were of Graf type I （1566 type Ia and 2172 type Ib）, 455 （10.83%） of type Ⅱ （240 type Ⅱa, 156 typeⅡb, 48 type Ⅱc, and 11 type Ⅱd）, 5 （0.12%） of type Ⅲ, and 2 （0.05%） of typeⅣ. Conclusion Ultrasound can provide accurate qualitative and quantitative assess- ments for the development of hip joints in young infants. It can be used as a preferred method for the early diagnosis of DDH.