婴幼儿发育性髋关节异常的早期诊断

目的 报道采用超声波髋关节检查技术诊断新生儿和小婴儿发育性髋关节异常(DDH)和早期处理的初步经验。方法 2002年4月～2002年9月，391例临床怀疑DDH，年龄小于l岁的婴幼儿在上海儿童医学中心接受了超声波髋关节检查，其中男193例(49．4％)，女198例(50．6％)。最小年龄5d，最大年龄354d。其中新生儿24例(6．14％)，2个月婴儿52例(13．30％)，3个月婴儿54例(13．81％)，4～6个月婴儿164例(41．94％)，6～12个月婴儿97例(24．81％)。参照Graf等分类方法，检查者被分为五类，其中髋关节发育不良、髋关节半脱位和髋关节全脱位者定为DDH。髋关节发育不成熟者采取随访观察。年龄小于6个月的DDH接受了早期Pavlik吊带治疗，并采用超声波跟踪，决定治疗的终止或改动。结果 300例超声波检查正常，91例超声波检查阳性，其中42例诊断为DDH。接受随访的35例髋关节发育不成熟病例中，29例自行恢复。Pavlik吊带治疗在小于6个月DDH婴幼儿中成功率为91．67％。结论 采用超声波髋关节诊断技术可以早期发现新生儿和小婴儿DDH，并施行早期治疗，可以提高DDH在儿童期的治愈率，减少漏诊病例，简化治疗，提高疗效。

Early diagnosis of developmental dysplasia of hip in infants: Preliminary report of ultrasonographic examination of 391 cases

Objective To report the experiences in ul trasonographic diagnosis of developmental dysplasia of the hip (DDH) with early treatment in the neonate and infants. Methods 391 infants, suspected of DDH, underwent ultraso nic examination. The patients were classified into five categories according to Graf's classification. Hip dysplasia, subluxation and dislocation were included in DDH. Immature hips were follow-up with ultrasound. DDH patients under six mo nths of age were treated with Pavlik sling. Results Ninety-one infants had positive ultrasonographic findings including 42 with DDH. 82.86 % of the followed-up cases with immat ure hip developed to normal range without treatment. 91.67 % of patients unde r six months of age had good results using Pavlik sling. Conclusions The authors recommend ultrasonographic examin a tion for suspected DDH during neonate and early infancy periods. Early diagnosis and treatment would achieve good efficacy.