婴幼儿发育性髋关节发育不良的超声筛查——130例婴幼儿筛查分析

目的 探讨超声在婴幼儿发育性髋关节发育不良(DDH)诊断中的临床价值.方法 选取2014年10月至2015年11月在北京妇产医院健康体检的6个月内婴幼儿1301例(2602个髋关节)进行Graf法髋关节超声检查,对髋关节进行测量及分型,确定正常、可疑、异常髋关节;对初筛检出的可疑患儿1个月后复查髋关节超声,并对结果 进行分析.结果 正常髋关节占96.85%(2520/2602),可疑髋关节占2.69%(70/2602),异常髋关节占0.46%(12/2602),左侧髋关节DDH检出率明显高于右侧(χ2=7.59,P<0.05).双侧髋关节均无异常的婴儿占96.62%(1257/1301),可疑患儿占2.92%(38/1301),异常患儿占0.92%(12/1301),女婴DDH检出率明显高于男婴(χ2=90.38,P<0.05),臀位产婴儿DDH检出率均明显高于其他组婴儿(χ2=3.84,P<0.05).对38例可疑病例进行超声随访,有2.38%(31/1301)于首次复查时恢复正常,有0.31%(4/1301)于第2次复查时恢复正常,有3例转为异常患儿.结论 超声检查能有效地评估婴幼儿髋关节发育情况,可作为婴幼儿DDH早期筛查和随访的主要手段,为早期干预治疗起到重要作用.

Ultrasonic screening of developmental dysplasia of the hip in infants-screening analysis of 130 cases

Objective To explore the clinical value of ultrasound in diagnosis of infants with developmental dysplasia of the hip ( DDH) . Methods A total of 13010-6 months old infants (2602 hips) taking health examination in Beijing Obstetrics and Gynecology Hospital were examined with ultrasound from October 2014 to November 2015, and all hip joints were measured and judged types by Graf's method to determine normal, suspicious and abnormal hips.The infants suspected were examined with ultrasound again after one month, and the results were analyzed.Results Among the hips normal ones occupied 96.81% (2519/2602), suspected ones occupied 2.69% (70/2602), and abnormal ones accounted for 0.49%(13/2602).The detection rate of DDH in left hips was higher than in right hips (χ2 =7.59,P<0.05).Infants with normal two hips occupied 96.62% (1257/1301), those with suspected ones occupied 2.92% (38/1301), and those with abnormal ones occupied 0.92%(12/1301).The detection rate of DDH in female infants was higher than that in male ones (χ2 =90.38,P<0.05), and that of infants with breech presentation was higher than those with other position (χ2 =3.84,P<0.05).Among 38 suspected infants followed up, there were 2.38% developing into normal at first reexamination (31/1301), 0.31%developing into normal abnormal at second reexamination (4/1301), and 3 cases developed into abnormal ones.Conclusion Ultrasonic examination can evaluate the development of infant's hips effectively.It can serve as a major method for early screening and following up of DDH in infants, and thus plays an important role in early intervention treatment.