Graf法超声对0~6个月婴幼儿发育性髋关节发育不良的诊断价值

目的 探讨分析Graf法超声对0~6个月婴幼儿发育性髋关节发育不良(DDH)的诊断价值, 以期为DDH的筛查提供参考。方法 对甘肃省金昌市第一人民医院于2014年7月-2019年10月期间收治的疑似发育性髋关节发育不良的1 393例0~6个月婴幼儿行Graf法超声检查, 并进行临床及X线检查作为“金标准”判断是否为发育性髋关节发育不良, 分析Graf法超声诊断结果、诊断的准确度、特异度及敏感度, 异常与正常髋关节α角、β角的差异, 以及Graf法超声复查随访情况。结果 1)1 393例行Graf法超声检查婴幼儿中, DDH检出率为5.60%, 女性所占比例明显高于男性, 臀位分娩所占比例明显高于非臀位分娩(P＜0.05)。在被检的2 786个髋关节中, 髋关节异常率4.74%;异常髋关节的α角明显小于正常髋关节, 而β角明显大于正常髋关节(P＜0.05)。2)Graf法超声诊断发育性髋关节发育不良准确度为100%, 特异度为99.87%, 敏感度为100%。3)Graf法超声复查随访, 278个Ⅱa型髋关节中有96个转为了Ⅰ型;10个Ⅱb型髋关节有4个转为了Ⅰ型;132个异常髋关节经石膏固定或Pavlik吊带治疗后均转为了正常髋关节。结论 Graf法超声对于0~6个月婴幼儿发育性髋关节发育不良具有良好的诊断价值, 值得在临床上推广应用。

Value of Graf ultrasound in the diagnosis of developmental hip dysplasia in infants aged 0 to 6 months

Objective To investigate the diagnostic value of Graf ultrasound in the development of developmental hip dysplasia (DDH) in infants aged 0-6 months, in order to provide reference for clinical screening for DDH. Methods A total of 1 393 infants with suspected DDH admitted to the neonatal ward of Jinchang First People's Hospital from July 2014 to October 2019 were examined by Graf ultrasound, and clinical and X-ray examinations were performed as the "gold standard" to determine DDH.Graf ultrasound diagnosis results, diagnostic accuracy, specificity, and sensitivity were analyzed, and the differences on α and β angles between normal hip abnormal and DDH were compared. Results 1) Among 1 393 infants who underwent Graf ultrasound examination, the detection rate of DDH was 5.60%.The proportion of DDH in female infants was significantly higher than that of male infants, and the proportion of breech delivery in infants with DDH was significantly higher than that of non-breech delivery (P <0.05).Among the 2 786 hip joints examined, the hip joint abnormality rate was 4.74%.Moreover, α angle of the abnormal hip joint was significantly smaller than that of the normal hip joint, β angle was significantly larger than that of the normal hip joint (P <0.05).2) The accuracy of Graf ultrasound in the diagnosis of developmental hip dysplasia was 100%, the specificity was 99.87%, and the sensitivity was 100%.3) Totally 96 of 278 type Ⅱa hip joints were converted to type Ⅰ, 4 of 10 type Ⅱb hip joints were converted to type Ⅰ, and 132 abnormal hip joints were treated with plaster fixation or Pavlik sling Later all turned to normal hip joints during follow-up. Conclusion Graf ultrasound is of good diagnostic value for DDH in infants and young children aged 0~6 months, and it is worthy of clinical application.