不同月龄阶段婴幼儿发育性髋脱位超声图像及各参数值相关分析

目的 探讨不同月龄阶段正常髋关节及发育性髋脱位超声测值的变化,为婴幼儿发育性髋脱位的诊断提供客观依据.方法 应用超声检查311例婴幼儿622个髋关节,正常378髋,异常244髋,观察髋关节形态结构并测量相关参数指标[α角、β角、髋臼角(AI)、股骨头覆盖率(FHC)],分组(每3个月为一组)统计各参数测值并进行相关分析.结果 超声可以清晰显示髋关节形态结构、头臼位置关系,并依据相关参数测值对髋关节是否异常和异常程度进行判断.正常组髋关节参数测值分析结果:①α角、β角、AI、FHC测值不同月龄组组间比较差异有显著性统计学意义(P＜0.01);②各参数测值与婴幼儿月龄之间存在相关性,其中α角、FHC测值与月龄间存在正相关(rα=0.537,P＜0.01;rFHC=0.554,P＜0.01);β角、AI测值与月龄间存在负相关(rβ=-0.465,P＜0.01;rAI=-0.424,P＜0.01);③各参数测值间存在相关性,α角与β角测值、α角与AI测值之间均存在负相关,其中α角与AI测值之间存在密切负相关(r=-0.794,P＜0.01).异常组各型髋关节不同月龄阶段参数测值分析结果表明髋关节α角、β角、AI、FHC测值不同月龄组组间比较差异无统计学意义(P＞0.05),但各型髋关节的α角与AI测值之间亦存在密切负相关.结论 超声检查可作为婴幼儿DDH早期确诊手段及首选的筛查手段;对于大龄(＞6个月)患儿将各项参数测值同月龄结合进行分析,准确性更高.

Ultrasonography on developmental dislocation of the hip in infants of different months and the correlation analysis of each parameter index

Objective To discuss the changes of correlative ultrasonic parameter index of normal hips and abnormal hips with developmental dislocation of the hip (DDH) in infants of different months in order to provide objective information for the diagnosis. Methods Three-hundred and seventy-eight normal hips and 244 hips with DDH among 622 hips of 311 infants were detected by ultrasonography(US). The morphology and structure information of hips were observed, and the values of ultrasonic parameter index,including angle α,angle 3, acetabular index( AI), femoral head percentage of cover(FHC) of normal hips and abnormal hips were measured. The values of each parameter index were collected by being divided into different groups (3 months a group) ,then the correlation was analyzed. Results Morphology and structure,position relation between femoral head and acetabulum of the hips were demonstrated by US. Normal or abnormal hips,the degrees of abnormal hips and the types of hips could be judged according to the findingsof US. Analysis of values of parameter index of normal hips:①There was significantly statistical significance in the values of ultrasonic parameter index, such as angle α, angle β, AI, FHC of normal hip between the groups of different age (P＜0.01). ②There was correlation between the age and the values of each parameter index, among which angle α, FHC had positive correlations with age ( r = 0. 537, 0. 554,respectively ) while angle β and Al negative correlations ( r = -0. 465, -0.424, respectively ). ③There was correlation between the values of different parameter index. Both angle β and AI had negative correlation with angle α,among which the latter correlation was closely ( r = - 0. 794). No statistical significance was found between the ultrasonic values of each group under different ages of different type abnormal hips( P ＞0.05) ,but closely negative correlations still existed between angle α and AI. Conclusions US can be viewed as an early definite and a screening method of diagnosing DDH.For older infants (above 6 months) it will be more accurate to analyze the ultrasonic parameter index together with the age of infants.