大连地区婴幼儿发育性髋关节发育不良初步筛查及高危因素分析

Preliminary screening of infants with developmental dysplasia of the hip and analysis of risk factors in Dalian

目的分析大连地区发育性髋关节发育不良(developmental dysplasia of the hip,DDH)的高危因素,探讨符合本地区特点的早期筛查方法和模式。方法自2013年1月1日至2014年12月31日由大连市区县妇幼机构和大连市妇女儿童保健中心、大连市儿童医院共计筛查14 736例婴幼儿髋关节发育情况,运用SPSS19.0软件对患者的临床资料进行单因素分析和多因素Logistic回归分析,观察DDH的危险因素。结果共计14 736例婴幼儿,可疑患儿472例(32.03‰,472/14736),专科检查后确诊患儿56例(3.80‰,56/14736)(69髋)。男童9例(11髋),女童47例(58髋),男女比1∶5.22;左侧45髋(65.22%),右侧24髋(34.78%),左右侧别比1.87:1。经过多因素非条件Logistic回归分析,结果显示臀位产、家族史、合并畸形、襁褓捆绑、羊水少、臀纹不对称为DDH发病的危险因素(P<0.05)。结论大连市采取对婴幼儿进行初筛-复筛确诊的模式,可以早期发现和确诊DDH,本地区DDH高危因素包括臀位产、家族史、合并畸形、襁褓捆绑、羊水少、臀纹不对称,建议建立完备的筛查体系,推广DDH的早期筛查工作。

Objective To explore the risk factors of developmental dysplasia of the hip （DDH） and val- idate early screening method in Dalian. Methods From January 1, 2013 to December 31, 2014, a total of 14736 cases from municipal district women ＆ childrcng organizations, women ＆ children heahhcare center and Dalian Children＇s Hospital were retrospectively analyzed. SPSS19. 0 software was used for ana/yzing their clini- cal data with single and muhivariable Logistic regression. And the risk factors of DDH recor- ded. Results Among them, there were 472 suspected cases （32.03 %o, 472/14736）. Specialized examina- tions corffirmed 56 cases （3. 80 %v, 56/14736） （69 hips）. There were 9 boys （ 11 hips） and 47 girls （58 hips） with a ratio of boy： girl at 1：5.22. There were 45 left （65.22%） and24 right （34.78%） hips with a ratio of left ： right at L 87 ： 1. Through unconditioned Logistic regression analysis of multiple factors, breech de- livery, family history of DDH, associated malformation, infant bundling, deficient amniotic fluid and asymmet- ric hip grain were risk factors of disease （ P 〈 0. 05 ）. Conclusions The primary - secondary screening diagnosis model helps to diagnose DDH early and identify the risk factors of DDH in Dalian. And a complete system of screening is needed for promoting early screening of DDH.