德州地区婴儿发育性髋关节异常的超声早期筛查及流行病学研究

Study of Ultrasound early screening and epidemiological results of developmental hip abnormalities in infants in Dezhou

目的分析德州市婴儿发育性髋关节异常(DDH)流行病学结果,分析超声早期筛查DDH患儿的临床价值,为提升婴儿健康保健质量提供参考。方法采用超声Graf法结合Harcke法对2016年12月～2017年12月期间在我院行儿保检查的4个月内婴儿4000例进行髋关节检查。详细记录每次检查时的超声测量结果,阳性病例复查,对筛查出的患儿进行综合干预,记录其转归情况。按照性别、月龄、出生体重、阳性体征、合并症、胎儿期胎位、羊水量、孕妇情况、家族史等统计婴儿髋关节超声检查结果,分析婴儿DDH患儿的临床特点。探讨早期超声筛查婴儿发育性髋关节异常的对策。结果 4000例婴儿共筛查出发育性髋关节异常88例,患病率2.2%。体格检查共发现11例DDH患儿,超声Graf法检出61例,Harcke检出70例。超声Graf法联合Harcke法检出88例DDH患儿,超声Graf法联合Harcke法检出DDH阳性率显著高于体格、单纯Graf法和单纯Harcke法(P<0.05)。超声Graf法和Harcke法诊断DDH类型有基本的对应关系。低月龄、发育性髋关节脱位家族史、先天性马蹄内翻足、肌性斜颈、四肢畸形、臀位产、剖宫产、女婴并发DDH风险较大(P<0.05)。88例发育性髋关节异常患儿经综合干预后,髋关节均恢复正常。结论 DDH在婴儿期发病率较高,超声Graf法结合Harcke法可有效筛查早期DDH,及早采取干预措施予以纠正,提升婴儿优育水平。

Objective： To analyze the epidemiological results of developmental dysplasia of the hip （DDH） in infants in Dezhou, and to analyze the clinical value of early screening for DDH in children, so as to provide references for improving the quality of infant health care. Methods： During the period December 2016-2017 year in January 4000 cases of infant hip check in 4 months in our hospital for child health examination in combination with Harcke method using ultrasonic Graf. The results of ultrasonic measurement at each examination were recorded in detail, and the positive cases were reviewed. According to gender, age, birth weight, positive signs, complications, fetal malposition, amniotic fluid volume, pregnant women, family history and statistics of infant hip ultrasound findings, clinical features of hip dysplasia in children with infantile differences. To explore the Countermeasures of early ultrasonic screening of developmental dysplasia of the hip in infants. Results： 88 cases of developmental dysplasia of the hip were found in 4000 cases. The prevalence rate was 2.2%. 11 cases of DDH were found in the physical examination, 61 cases were detected by ultrasonic Graf, and 70 cases were detected by Harcke. Ultrasonic Graf and Harcke were used to detect 88 cases of DDH. The positive rate of DDH detected by Graf combined with Harcke was significantly higher than that of body, Graf and Harcke alone （P〈0.05） . There is a basic correspondence between the ultrasonic Graf method and the Harcke method in the diagnosis of DDH type. Low age, family history, developmental dislocation of the hip with congenital clubfoot, torticollis, limb deformities, breech delivery and cesarean section were complicated with DDH risk （P〈0.05） . 88 children with developmental dysplasia of the hip were restored to normal after comprehensive intervention. Conclusion： DDH in infants with high incidence, can be effective in screening for early DDH Harcke method combined with ultrasonic Graf method, to take early intervention measures to correct and improve the level of infant.