超声筛查发育性髋关节发育不良高危婴儿的临床价值

Clinical value of ultrasound screening high risk infants with developmental dysplasia of 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例在笔者所在医院儿保科、儿科及儿外科就诊的婴儿,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检查,采用Graf法和Graf髋关节病理分型对所有检查结果进行统计和分析。结果 976个受检髋关节中,Ⅰ型髋关节914个,占93.7%(914/976);Ⅱ型髋关节49个,占5.0%(49/976),其中ⅡA型25个,ⅡB型13个,ⅡC型11个;D型髋关节4个,占0.4%(4/976);Ⅲ型髋关节7个,占0.7%(7/976);Ⅳ型髋关节2个,占0.2%(2/976)。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。

Objectives To explore the clinical application value of Graf ultrasonic method in screening positive signs of merging other risk factors in baby with developmental dysplasia of the hip. Methods In 488 cases in author＇s hospital child health care department,pediatrics department and surgery clinic of infant,clinical examination suggested 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.）. By using hip Graf ultrasound method and Graf hip pathology classification all screening results got statistical analysed. Results In 976 cases,914 were tested I type hip,accounted for 93.6%（914/976）; Ⅱ type hip 49,5.1%（49/976）,including Ⅱ type A 25, Ⅱ type B 13,Ⅱ C type Ⅱ;4,D type hip,accounted for 0.4%（4/976）;Hip of m type 7,0.7%（7/976）;IV type hip 2,0.2%（2/976）. Conclusion Ultrasound screening high-risk infant＇s dysplasia of the hip is the preferred method,and can be used in comparison of the incidence differences between different high risk infants.