伊犁地区婴幼儿发育性髋关节发育不良的危险因素分析

Risk factors for developmental dysplasia of the hip in infants in Yili Area

目的调查伊犁地区婴幼儿发育性髋关节发育不良(developmental dysplasia of the hip,DDH)的院内筛查结果,并分析影响DDH发生的风险因素。方法按照整群抽样法,选取2019年12月至2022年6月于新疆生产建设兵团第四师医院儿保门诊及骨科门诊进行DDH普查的5536例婴幼儿为研究对象。筛选出符合DDH诊断标准的患儿为观察组(n=35),另选择100例正常婴幼儿为对照组。采用单因素和多因素分析法确立影响婴幼儿DDH发生的独立风险因素。结果初筛阳性者39例,复筛阳性者35例,阳性率6.32‰。单因素分析结果显示,观察组女患儿、二胎及以上、剖腹产、产时臀位、有家族史、高海拔地区、居住环境室温<18℃、襁褓时绑腿的比例高于对照组(P<0.05)。logistic回归分析显示:生产方式、地域、居住环境室温及襁褓方式是影响婴幼儿发生DDH的独立风险因素(P<0.05)。结论剖腹产、高海拔地区、居住环境室温<18℃及襁褓中绑腿是婴幼儿DDH的发生相关,可为临床筛查和诊治提供一定的参考依据。

Objective To investigate the in-hospital screening results of developmental dysplasia of the hip(DDH)in infants and young children in Ili Area,and to analyze the risk factors affecting the occurrence of DDH.Methods According to the cluster sampling method 5536 infants and young children who underwent DDH screening in the pediatric outpatient department and orthopedic outpatient department of our hospital from December 2019 to June 2022 were selected as the research objects.The children who met the diagnostic criteria of DDH were selected as the observation group(n=35),and 100 normal children were selected as the control group.Univariate and multivariate analysis were used to determine the independent risk factors affecting the occurrence of DDH in infants.Results Among the 39 cases were positive in primary screening,35 cases were positive in secondary screening,and the positive rate was 6.32‰.The results of single factor analysis showed that the proportion of women,second birth and above,caesarean section,breech delivery,family history,high altitude Area,living environment room temperature<18℃,and leg binding when swaddling in the observation group was higher than that in the control group(P<0.05).Logistic regression analysis showed that mode of production,region,room temperature of living environment and swaddling mode were independent risk factors for DDH in infants(P<0.05).Conclusion Caesarean section,high altitude Area,living environment room temperature<18℃and leg binding in infants are related to the occurrence of DDH in infants,which can provide some reference for clinical screening,diagnosis and treatment.