应用Graf法多学科联合进行发育性髋关节发育不良的极早期筛查与诊治

Application of Graf method in multidisciplinary joint for extremely early screening,diagnosis and treatment of developmental hip dysplasia

目的分析发育性髋关节发育不良(DDH)运用Graf法进行极早期筛查的状况及诊治效果,为临床防治DDH提供参考依据。方法采用前瞻性随机试验方法选取2019年1月至2020年1月于九江市妇幼保健院行常规髋关节彩超检查的2000例婴儿作为研究对象,于6周龄利用Graf法筛查,并根据筛查结果进行分级治疗(Ⅰ型无需特殊处理;Ⅱa级及以上的患儿进行骨科体检及指导治疗),并于3、6个月龄进行复查,观察恢复至转阴的情况。结果2000例筛查对象中,阳性为86例,占4.30%;3个月龄进行复查,86例阳性患儿中,81例为Ⅰ型,转阴率为94.19%;6月龄进行复查,84例为Ⅰ型,转阴率为97.67%。结论应用Graf法对DDH患儿进行极早期筛查与分级诊治利于改善患儿髋关节结构形态,促进儿童健康成长,值得临床推广运用。

Objective To analyze the developmental dysplasia of the hip(DDH)using the Graf method for very early screening and the diagnosis and treatment effect,and provide a reference for the clinical prevention and treatment of DDH.Methods 2000 infants who underwent conventional color Doppler ultrasound examination at Jiujiang Maternity and Child Health Hospital from January 2019 to January 2020 were selected as the research subjects used a prospective randomized trial method.All were screened by Graf method at 6 weeks of age.The screening results are treated with graded treatment(typeⅠdoes not require special treatment;children with gradeⅡa and above shall undergo orthopedic physical examination and guided treatment),and re-examination shall be performed at the age of 3 and 6 months to observe the recovery to negative status.Results Among the 2000 cases screening subjects,86 cases were positive,accounting for 4.30%;3 months of age were re-examined,of 86 cases positive patients,81 cases were typeⅠ,the negative conversion rate was 94.19%;6 month of age were re-examined,84 cases were typeⅠ,and the negative conversion rate was 97.67%.Conclusion The application of Graf method to the very early screening and grading diagnosis and treatment of children with DDH is beneficial to improve the hip joint structure and promote the healthy growth of children.It is worthy of clinical application.