2015—2020年33954例婴儿髋关节超声筛查结果分析

Analysis on ultrasonic screening results of infant hip joint in 33954 infants from 2015 to 2020

目的 了解33 954例婴儿发育性髋关节发育不良发生情况,探究超声筛查在婴儿髋关节发育不良早期发现中的临床应用价值。方法 选取2015—2020年在江苏省妇幼保健院儿童保健科常规体检筛查及经临床检查高度怀疑髋关节发育不良的33 954例婴儿,共67 908个髋关节,采用Graf超声技术观察婴儿髋关节形态,测量α、β角并进行分型,对结果进行统计分析。结果 33 954例婴儿中,筛查出髋关节发育异常4 690例,其中生理性不成熟4 313例,需要干预的发育性髋关节发育不良377例(1.11%)。女婴髋关节发育异常共2 537例,男婴髋关节发育异常共2 153例,女婴髋关节发育异常检出率(15.40%)显著高于男婴(12.31%),差异有统计学意义(χ^(2)=68.004,P<0.05)。女婴发育性髋关节发育不良检出率(1.48%)显著高于男婴(0.77%),差异有统计学意义(χ^(2)=140.64,P<0.05),男女发育性髋关节发育不良比例为1∶1.81。在检出的377例发育性髋关节发育不良婴儿中,左侧发育不良髋关节262个,右侧发育不良髋关节211个,差异有统计学意义(χ^(2)=50.37,P<0.05)。共检出发育性髋关节发育不良473个,包括Ⅱa型456个,Ⅱb型12个,Ⅱc型2个,Ⅱd型1个,Ⅲ型1个,Ⅳ型1个。结论 早期应用Graf法髋关节超声检查能有效评估婴儿髋关节发育情况,是早期发现和随访髋关节发育不良的主要手段,在早期诊断、早期治疗中起到了重要作用。

Objective To investigate the occurrence of developmental dysplasia of the hip of infants in 33954 infants,and explore the clinical application value of ultrasound screening in early detection of developmental dysplasia of the hip in infants.Methods From 2015 to 2020,33954 infants with highly suspected hip dysplasia after conventional physical examination and clinical examination in Department of Child Health Care of Jiangsu Maternal and Child Health Hospital were selected,67908 hip joints were included,Graf ultrasound technology was used to observe the morphology of infant hip joints,αandβangles were measured and classified,and the results were statistically analyzed.Results Among 33954 infants,4690 cases of abnormal hip joint development were screened out,including 4313 cases of physiological immaturity and 377 cases of developmental dysplasia of the hip(1.11%).A total of 2537 cases were found in females and 2153 cases in male.The detection rate of hip dysplasia in female infants(15.40%)was significantly higher than that in male infants(12.31%)(χ^(2)=68.004,P<0.05).The detection rate of hip dysplasia in female infants was 1.48%,which was higher than that in male infants,there was statistically significant difference(χ^(2)=140.64,P<0.05),the ratio of male and female developmental dysplasia of the hip was 1∶1.81.Among 377 infants with developmental dysplasia of the hip,262 hip joints on the left hip and 211 hip joints on the right hip were included,there was statistically significant difference(χ^(2)=50.37,P<0.05).A total of 473 hip joints of developmental dysplasia were detected,including 456 hip joints ofⅡa type,12 hip joints ofⅡb type,2 hip joints ofⅡc type,1 hip joint ofⅡd type,1 hip joint ofⅢtype,and 1 hip joint ofⅣtype.Conclusion Early application of Graf hip ultrasound can effectively assess the development of hip joint of infants,which is the main means of early detection and follow-up of developmental dysplasia of the hip,and it plays an important role in early diagnosis and early treatment.