超声对婴儿发育性髋关节异常的诊断及疗效评价

目的探讨超声动、静态检查相结合在婴儿发育性髋关节异常(DDH)早期诊断价值及早期治疗的疗效评价。方法对我院临床疑为DDH的67例患儿共134个髋关节进行高频超声动、静态检查,按照北美诊断标准及Harcke法进行诊断;对超声检查异常患儿在经过相应临床治疗后进行跟踪随访。结果初诊时超声检查按Graf诊断标准显示,Ⅰ型髋关节74个(55.2%),Ⅱa和Ⅱb型髋关节34个(25.4%),Ⅱc型髋关节16个(11.9%),D型髋关节3个(2.2%),Ⅲ型髋关节7个(5.2%);Harck法观察股骨头稳定性发现,Ⅱc型、D型及Ⅲ型可复位23个,不可复位3个。1个月后随访,仅3例Ⅱa型及Ⅱb型髋关节复查,且均为正常;18个Ⅱc型、D型和Ⅲ型髋关节用Pavlik支具治疗后复查,其中11个髋关节为Ⅰ型,3个髋关节为Ⅱb型,1个髋关节为Ⅱa型,1个髋关节转为Ⅱc型,3个髋关节无改变;2个月共复查12个髋关节,10个髋关节为Ⅰ型,2个为Ⅱb型。结论超声能有效显示6个月以内患儿的股骨头,对于DDH的早期诊断提供了可靠依据。

Diagnosis and curative effect evaluation of developmental dysplasia of hip in cases with ultrasonography

Objective To investigate the value of high frequency ultrasound combined with dynamic and static examination in early diagnosis and curative effect evaluation of developmental dysplasia of hip （DDH）. Methods The infants with clinically suspected DDH （67 cases of 134 hips） underwent high frequency ultrasonography combined with dynamic and static scanning. The diagnosis was performed according to the North American standard and Hareke method. Follow-up examination was performed post treatment. Results According to Graf method diagnostic criteria, 74 hips （55.2%） were in type Ⅰ ; 34 hips （ 25.4% ） were in type Ⅱa and Ⅱb, 16 hips （ 11.9% ） were in type Ⅱc, and 3 hips （2.2%） were in type D, 7 hips （5.2%）were in type m. 23 hips of type Ⅱc, type D and type m can be reset, while the other 3 couldn＇ t. During the first month follow-up, only 3 eases of type Ⅱa and Ⅱ b were re-examined, and all were normal; 18 hips of type Ⅱc, type D and type m treated with Pavlik harness were re-examined, 11 of them were normal, 3 hips were in type Ⅱb, 1 was in type 11 a, 1 was in type Ⅱc, 3 hips had no changes; a total of 12 hips were followed up during 2 months, 10 hips were normal, the other 2 were in type Ⅱb. Conclusion Ultrasound can effectively present the femoral head in children under 6 months old, which provides reliable basis for early diagnosis of DDH.