小儿髋关节发育不良诊断中超声检查的应用及其临床意义

目的 分析小儿髋关节发育不良诊断中超声检查的应用,为临床提供更多参考依据。方法 选取2018年1-12月宜昌市夷陵区妇幼保健院收治的筛查结果提示髋关节发育不良的儿童360例,均进一步行X线检查及超声检查;以所有儿童的最终临床诊断及随访6个月结果作为对比金标准。结果 360例婴儿经临床诊断及随访结果显示共有29例(8.1％)为髋关节发育不良。X线检查结果的诊断准确率为98.6％(355/360),超声检查结果的诊断准确率为99.4％(358/360)(P＞0.05)。X线检查组的诊断敏感度为93.1％,特异度为99.1％;超声查组的诊断敏感度为96.5％,特异度为99.7％,超声检查的诊断敏感度和特异度略微高于X线检查组,但差异无统计学意义(P＞0.05)。360例婴儿中,髋关节Ⅰ型(正常)婴儿为331例(91.9％);Ⅱ型(髋关节生理性发育未成熟)婴儿22例(75.9％),对X线检查组婴儿进行随访追踪,有15例在临床复查时为I型(正常髋关节),2例未发生变化,其余5例失访。结论 使用X线及超声检查均能准确诊断小儿髋关节发育不良;超声检查相比X线检查能够有效降低或者避免婴儿在接受检查过程中过多接受X线辐射,临床推广价值更高。

Application and clinical significance of ultrasound in the diagnosis of hip dysplasia in children

Objective To analyze the application of ultrasonic examination in the diagnosis of dysplasia of hip joint in children,so as to provide reference for clinical practice. Methods A total of 360 children with screening result of hip joint dysplasia were selected in Yiling Maternal and Child Health Hospital from January to December 2018,and took further X-ray examination and ultrasonic examination.The final clinical diagnosis and follow-up for 6 months in all children were used as the gold standard for comparison. Results Finally 29 (8.1%) of 360 infants were diagnosed with hip dysplasia.The diagnostic accuracy ratios of X-ray examination and ultrasonic examination were 98.6% (355/360) and 99.4% (358/360).The diagnostic sensitivity and specificity of the X-ray group were 99.7% and 99.1%,respectively.The diagnostic sensitivity and specificity of ultrasonic examination group were 96.5% and 91.9%,respectively.The diagnostic sensitivity and specificity of ultrasonic examination were slightly higher than that of X-ray examination,but there were no significant differences (P>0.05).Among 360 infants,331 (91.9%) were of type I (normal hip joint),and 22(75.9%) infants were detected with type Ⅱ (immature) hip physiological development,of whom 15 infants changed to type I (normal hip),2 infants had no change,and 5 infants lost during the follow-up. Conclusions X-ray and ultrasonic examination can diagnose hip dysplasia accurately.Compared with X-ray examination,ultrasonic examination can effectively reduce or avoid excessive exposure to X-ray radiation in the process of examination,which is of higher clinical promotion value.