高频超声Graf法结合Harcke法对小儿髋关节发育异常的诊断价值

Diagnostic value of high frequency ultrasound Graf method combined with Harcke method in children with hip dysplasia

目的探讨高频超声Graf法结合Harcke法对小儿髋关节发育异常的诊断价值。方法回顾性分析2019年2月至2022年2月超声科接诊的98例疑似髋关节发育异常患儿的临床资料,患儿均接受高频超声Graf法、Harcke法及X线检查(金标准)。分析X线检查结果;分析不同方法的阳性检出率、误诊率及漏诊率;比较不同方法对髋关节发育异常的诊断灵敏度、特异度、准确度、阴性预测值、阳性预测值;比较髋关节发育异常患儿治疗前、后的超声指标,分析超声检查对治疗效果的评估作用。结果X线检查结果显示,髋关节发育异常28例。不同方法的阳性检出率比较,差异无统计学意义(P>0.05);Graf法结合Harcke法的误诊率、漏诊率较低。Graf法结合Harcke法对髋关节发育异常的诊断灵敏度、特异度、阴性预测值、阳性预测值高于Graf法(P<0.05);Graf法结合Harcke法对髋关节发育异常的诊断准确度高于Graf法、Harcke法(P<0.05)。治疗后的α角大于治疗前,β角小于治疗前(P<0.05)。28例髋关节发育异常患儿经Pavlik吊带治疗后超声检查显示转为Ⅰ型26例,其他2例分别为Ⅲ型、Ⅳ型,超声显示治疗效果不明显。结论Graf法可对髋关节进行分型,Harcke法可评价髋关节稳定性,两者联合应用可通过充分发挥各自优势以判断髋关节发育状况。

Objective To explore the diagnostic value of high frequency ultrasound Graf method combined with Harcke method in children with hip dysplasia.Methods The clinical data of 98 children with suspected hip dysplasia diagnosed in the ultrasound department from February 2019 to February 2022 were retrospectively analyzed.All children underwent high frequency ultrasound Graf method,Harcke method and X-ray examination(gold standard).The X-ray examination result was analyzed;the positive detection rate,misdiagnosis rate and missed diagnosis rate of different methods were analyzed;the diagnostic sensitivity,specificity,accuracy,negative predictive value and positive predictive value of different methods for hip dysplasia were compared;the ultrasound indexes of children with hip dysplasia before and after treatment were compared,and the evaluation of ultrasound examination on treatment effect was analyzed.Results X-ray examination result showed that 28 cases of hip dysplasia.There was no significant difference in the positive detection rate of different methods(P>0.05);the misdiagnosis rate and missed diagnosis rate of Graf method combined with Harcke method were low.The sensitivity,specificity,negative predictive value and positive predictive value of Graf method combined with Harcke method in the diagnosis of hip dysplasia were higher than those of Graf method(P<0.05);the diagnostic accuracy of Graf method combined with Harcke method for hip dysplasia was higher than that of Graf method and Harcke method(P<0.05).Theαangle after treatment was larger than that before treatment,and theβangle was smaller than that before treatment(P<0.05).Ultrasound examination of 28 children with hip dysplasia after Pavlik sling treatment showed that 26 cases were converted to typeⅠ,and the other 2 cases were typeⅢand typeⅣ,respectively.Ultrasound showed that the treatment effect was not obvious.Conclusion Graf method can be used to classify the hip joint,and Harcke method can be used to evaluate the stability of the hip joint.The combination of the two methods can flully utilize their respective advantages to judge the development status of hip joint.