超声检查在婴幼儿发育性髋关节发育不良早期诊治中的应用分析

Application of ultrasonography in early diagnosis and treatment of infant developmental hip dysplasia

目的对于超声检查在婴幼儿发育性髋关节发育不良(DDH)早期诊治中的应用价值进行研究探讨。方法以在贵州中医药大学第一附属医院2020年6月-2022年8月间进行筛查的婴幼儿400例为观察对象,其中临床确诊DDH婴幼儿60例(共60个患病髋关节),对初步体格检查结果与超声筛查结果的一致性进行分析。依照Graf分型,初诊Ⅰ、Ⅱa、Ⅱb型者不作干预,Ⅱc、Ⅱd、Ⅲ、Ⅳ型者给予佩戴Pavlik吊带治疗,观察3个月后复查超声结果。结果初步体格检查关节弹响、外展受限与超声筛查结果的一致性中等,而初步体格检查臀纹不对称、双下肢皮纹不对称等结果与超声筛查结果的一致性一般或较低(P<0.01);干预前后髋关节超声指标分析结果显示:Ⅱa、Ⅱb、Ⅱc型2次α角差异有统计学意义(P<0.05),β角则无统计学差异(P>0.05);Ⅰ、Ⅱd、Ⅲ、Ⅳ型2次α角、β角均无统计学差异(P>0.05)。结论通过超声检查可对婴幼儿髋关节的发育提供动态监测,且可为评估DDH临床治疗效果提供可靠的依据。

Objective To study the value of ultrasonography in early diagnosis and treatment of developmental dysplasia of hip joint(DDH)in infants.Methods 400 infants were screened in our hospital from June 2020 to August 2022,including 60 infants with clinically diagnosed DDH(a total of 60 diseased hip joints).The consistency of preliminary physical examination results and ultrasound screening results was analyzed.According to Graf classification,newly diagnosed patients with typeⅠ,Ⅱa andⅡb were not treated with intervention,while patients with typeⅡc,Ⅱd,ⅢandⅣwere treated with Pavlik sling,and the ultrasound results were observed 3 months later.Results The consistency between the initial physical examination results of joint bounce,limited abduction,and ultrasound screening results is moderate,while the consistency between the initial physical examination results of asymmetric buttocks and lower limb dermatoglyphs and ultrasound screening results is generally or relatively low(P<0.01).The ultrasonic index analysis of hip joint before and after intervention showed that there was significant difference inαAngle ofⅡa,Ⅱb,Ⅱc type(P<0.05),but no significant difference inβAngle(P>0.05).There was no significant difference inαAngle andβAngle in typeⅠ,Ⅱd,ⅢandⅣ(P>0.05).Conclusion Ultrasonography can provide dynamic monitoring of hip joint development in infants and young children,and can provide a reliable basis for evaluating the clinical treatment effect of DDH.