超声筛查发育性髋关节发育不良高危婴儿的临床价值

The clinical value of high risk infants using ultrasound screening for developmental dysplasia of the hip

目的探讨应用超声Graf法筛查临床体征阳性合并其他高危因素婴儿发育性髋关节发育不良的临床价值。方法对488例临床体检提示有臀纹或大腿纹不对称、下肢长度差异、髋外展受限等阳性体征同时合并其他高危因素(女性、臀位妊娠、家族史或伴有其他骨骼肌肉畸形等)的婴儿进行髋关节超声Graf法检查,并与Graf髋关节病理分型进行对照分析。结果 976个受检髋关节中,Ⅰ型髋关节914个,占93.6%;Ⅱ型髋关节49个,占5.1%,其中ⅡA型25个,ⅡB型13个,ⅡC型11个;D型髋关节4个;Ⅲ型髋关节7个;Ⅳ型髋关节2个。合并臀位妊娠与合并家族史、合并家族史与合并其他骨骼肌肉畸形的婴儿不成熟髋关节及DDH髋关节阳性检出率比较差异均有统计学意义(均P<0.05)。结论超声是筛查高危婴儿发育性髋关节发育不良的首选方法,并可比较不同高危婴儿之间发病率的差异性。

Objective To explore the clinical application value for infants with positive signs combined with other risk factors of developmental dysplasia of the hip using ultrasonic Graf method screening. Methods Data of 488 infants with the asymmetry of the hip or thigh lines,lower limb length difference,such as the limited hip outreach abnormal signs and consolidate DDH was susceptible to other risk factors（female,breech pregnancy,family history or other musculoskeletal abnormalities,etc.） evaluated with hip ultrasound,Graf method and Graf hip pathology classification,were enrolled in this study.Results Altogether 976 hips were detected,including 914 hips of type Ⅰ（93.6%）,49 hips of typeⅡ（5.1%）,which included25 hips of type Ⅱ A,13 hips of type Ⅱ B,11 hips of type Ⅱ C;4 hips of type D,7 hips of type Ⅲ and 2 hips of type Ⅳ.Conclusion Ultrasound screening is useful to diagnose developmental dysplasia of the hip for high-risk infants,and the differences between different risk infants were compared.