曲靖地区0~14岁儿童发育性髋关节发育不良患病情况及相关因素分析

Prevalence of developmental dysplasia of the hip among children aged 0-14 years in Qujing region

目的了解曲靖地区0~14岁儿童发育性髋关节发育不良(developmental dysplasia of the hip,DDH)患病情况及相关危险因素,为科学实施三级预防策略提供支撑。方法选取2015年1月—2019年12月在曲靖地区妇幼保健医院进行健康体检的0~14岁1332例儿童作为研究对象。0~6月龄婴儿采用Graf超声筛查DDH,7月龄~14岁儿童采用X线检查筛查DDH。分析0~14岁儿童DDH流行特点及危险因素,根据结果制定疾病三级防治策略。结果1332例儿童中,DDH检出22例,检出率为1.65%;各年龄段DDH检出率比较,差异无统计学意义(χ^(2)=1.646,P>0.05);女性DDH检出率高于男性(χ^(2)=7.090,P<0.05),左侧髋关节DDH检出率高于右侧(χ^(2)=4.583,P<0.05);经单因素χ^(2)检验多因素logistic回归分析显示,羊水过少(OR=3.851)、臀位产(OR=2.064)、臀纹不对称(OR=2.776)和有家族史(OR=3.560)为0~14岁儿童DDH发病的独立危险因素(P<0.05)。结论0~14岁儿童DDH以女性和左侧髋关节多见,其中羊水过少、臀位产、臀纹不对称和有家族史为DDH发病的独立危险因素。DDH预防遵循三级防治策略,主要包括孕期监测羊水量、胎位,疾病初期对高危儿童筛检、家庭指导以及疾病期间对症治疗等。

Objective To investigate the prevalence of developmental dysplasia of the hip(DDH)and its related risk factors among children aged 0-14 years in Qujing region so as to provide supports for implementing tertiary prevention and treatment strategy.Methods We selected 1,332 children underwent physical examination in Qujing Maternal and Child Health Care Hospital from January 2015 to December 2019 to serve as the research subjects.Graf ultrasound was used to screen DDH among children aged 0-6 months,and X-ray was applied to screening DDH among children aged 7 months to 14 years.The epidemiological characteristics and risk factors of DDH in children aged 0-14 years were analyzed,and a three-level disease prevention strategy was formulated based on the results.Results Among the 1,332 children surveyed,22 cases of DDH were detected,with the prevalence rate of 1.65%.No statistically significant difference was found in the prevalence rate of DDH among different age groups(χ^(2)=1.646,P>0.05).The prevalence rate of DDH was higher in females than in males(χ^(2)=7.090,P<0.05)as well as higher in the left hip than in the right hip(χ^(2)=4.583,P<0.05).Multiple logistic regression analysis with univariateχ^(2) test showed that oligohydramnios(OR=3.851),breech presentation(OR=2.064),asymmetry of gluteal lines(OR=2.776)and having a family history(OR=3.560)were the independent risk factors for DDH in children aged 0-14 years(P<0.05).Conclusion Among the children aged 0-14 years,DDH is more common in females and left hip joint,of which deficient amniotic fluid,breech delivery,asymmetric hip grain,and having a family history of DDH are the independent risk factors for the onset of DDH.DDH prevention should follow the three-level prevention and treatment strategy,mainly including monitoring amniotic fluid volume during pregnancy,fetal position,screening children at high risk in the early stages of disease,family guidance and symptomatic treatment during the onset of disease.