对医院出生儿先天性髋脱位防治措施的研究

目的:探讨对医院出生儿先天性髋脱位(CDH)早期发现和有效防治的途径。方法:调查总结6年间3家医院11256例在医院出生儿的相关临床资料,根据Lehmann和Garvey评定标准〔1,2〕,从中筛选出CDH易患儿,常规为其应用外展尿布或兜带进行护理3~4个月,进行影像和病理学检查,从中确认不稳定髋(髋臼发育不良或半脱位)患儿,及时采取非传统关节切开手术治疗,总结分析临床疗效。结果:11256例医院出生儿中CDH易患儿为189例,占16·8‰。这些易患儿经采用简便防护措施3~4个月,确诊为不稳定髋者8例,占0·71‰,上述8例患儿经非传统手术等治疗6~18个月,均获治愈。脱位畸形预防成功率100%,无股骨头坏死发生。结论:通过对医院出生儿进行普查和跟踪随访,可尽早发现有CDH发生倾向的患儿,及时为这些患儿采取相应防护措施,能够达到避免关节切开手术,预防脱位发生的治疗目的。

Study of prevention and treatment for neonatal with congenital dislocation of hip in hospital

Objective:To Study effective measure to prevente and treatment for the neonatal in hospital with congenital hip dislocation. Methods:Undertook a prospective study from July 1998 to June 2004 of 11256 living births, and selected according to Lehmann and Garvey's criterion. The babies were cared by abductive diaper or plumb-belt immediately for 3~4 months and were examined by radiography and physical examination With instability hip examined were being fixed by traction-reduction brace for more than half year before becoming normal. Results:11 256 neonates in hospital had been studied, 189(16.8‰) of them at risk for congenital hip disloction were selected, 8(0.71‰) instability hip were confirmed after using the diaper or plumb-belt for 3~4 months, and were all fixed by the brace during 6~18 months. All are cured,the succeed rate is 100% and no thighbone putrescence. Conclusion:The situation of them at risk for cogenital hip dislocation and instability hip can be found early and treated timely.We believe that deformation of hip dislocation can be prevented by over procedures.