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目的探讨新生儿发育性髋关节异常(DDH)的发病情况。方法选取2008年6月-2009年7月在本院住院和门诊就诊的762例足月新生儿(男382例,女380例)。患儿均采用Graf法和Morin法相结合的超声检查手段进行髋关节测量。参照Graf分类方法将髋关节发育不良、髋关节半脱位和髋关节全脱位者定为DDH。对髋关节发育不良患儿采取随访观察,而对髋关节半脱位和髋关节全脱位的DDH患儿行早期Pavlik吊带治疗,同时采用超声跟踪随访6个月,以进一步决定治疗方案。结果 1.143例DDH新生儿中髋关节脱位的发病率为0.52%,髋关节发育不良的发病率为18.25%;2.健康新生儿619例髋关节超声测量指标α角、β角、股骨头覆盖率的正常值分别为(60.19±6.92)度、(45.25±7.29)度、(62.85±6.38)%,DDH患儿分别为(44.52±7.53)度、(58.45±10.36)度、(37.65±7.74)%,二组超声测量指标比较差异均有统计学意义(Pa<0.05);3.性别、胎位、分娩产式、左侧等均为髋关节脱位的高危因素。结论 1.超声检查是新生儿DDH筛查的首选方法。2.明确新生儿髋关节发育的指标、DDH的发病率及相关高危因素,有利于减少DDH发生,同时早期发现DDH、尽早治疗,可改善患儿预后。
Objective To investigate the incidence of developmental abnormality of hip (DDH) in neonates. Methods A total of 762 full-term newborns (382 males and 380 females) were enrolled in our hospital and outpatient department from June 2008 to July 2009. Children with Graf method and Morin method combined ultrasound examination of hip measurements. According to Graf classification of hip dysplasia, hip subluxation and total dislocation of the hip as DDH. Follow-up observation was made on children with dysplasia of the hip. However, patients with DDH with subluxated hip and total hip dislocation were treated with Pavlik sling early and followed up for 6 months by ultrasound to further determine the treatment plan. Results The incidence of hip dislocation was 0.52% in neonates with DDH in 1.143 cases and 18.25% in dysplasia of hip joint. 2. The measurement of α, β and femoral head coverage in 619 healthy newborns (44.52 ± 7.53) degrees, (58.45 ± 10.36) degrees and (37.65 ± 7.74) degrees respectively in children with DDH were (60.19 ± 6.92) and (45.25 ± 7.29) and (62.85 ± 6.38)%, respectively %, Respectively. There was significant difference between the two groups in the measurement of ultrasound (P0.05) .3. Gender, fetal position, labor and left side were the risk factors of dislocation of the hip. Conclusion 1. Ultrasound is the preferred method of neonatal DDH screening. Clear neonatal indicators of hip development, the incidence of DDH and related risk factors, is conducive to reduce the occurrence of DDH, while early detection of DDH, early treatment can improve the prognosis of children.