X线测量在脑瘫患儿继发髋关节发育不良中的临床应用价值初步分析
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摘要
目的通过分析脑瘫(CP)患儿髋关节X线的相关指标,明确各测量指标的临床应用价值,寻求适合临床医师应用的CP患儿继发髋关节发育不良的监测方法。方法回顾性分析50例CP患儿的100个髋关节的X线相关指标,并以正常儿童30例作为对照,测量指标包括髋臼指数(AI)、颈干角(NSA)、股骨头偏移百分比(MP)。结果≤2岁CP患儿与同年龄段正常儿童骨盆平片相关指标对比显示:AI、NSA、MP差异均无统计学意义(P> 0. 05)。2～3岁CP患儿与同年龄段正常儿童骨盆平片相关指标对比显示:NSA、MP差异均有统计学意义(P <0. 05),AI差异无统计学意义(P> 0. 05)。> 3岁脑瘫患儿与同年龄段正常儿童骨盆平片相关指标对比显示:NSA、MP差异均有统计学意义(P <0. 05),AI差异无统计学意义(P> 0. 05)。结论 NSA和MP均是反映CP患儿髋关节发育异常的有效指标。
Objective To analyze the correlation of X-ray index in children with cerebral palsy( CP) and normal children,clarify the clinical application value of each measurement index,explore a method for monitoring hip dysplasia in children with CP suitable for clinician applications. Methods A retrospective analysis was X-ray correlation index of 100 hips in 50 children with cerebral palsy with 30 normal children as the control group,measurements included acetabular index( AI),neck shaft angle( NSA) and migration percentage( MP). Results Comparison of indicators related to pelvic plain film in children with ≤2 years old and normal children in the same age group,there was no statistical significance in AI,NSA and MP of the radiograph of the pelvis. Compared the normal pelvis in children with children with cerebral palsy in 2-3 years old,both NSA and MP had statistical significance while AI had no statistical significance. Compared the normal pelvis in children with CP children more than 3 years old,both NSA and MP had statistical significance while AI had no statistical significance. Conclusion Both NSA and MP are effective indicators to reflect secondary subluxation of the hip joint in children with cerebral palsy.
Objective To analyze the correlation of X-ray index in children with cerebral palsy( CP) and normal children,clarify the clinical application value of each measurement index,explore a method for monitoring hip dysplasia in children with CP suitable for clinician applications. Methods A retrospective analysis was X-ray correlation index of 100 hips in 50 children with cerebral palsy with 30 normal children as the control group,measurements included acetabular index( AI),neck shaft angle( NSA) and migration percentage( MP). Results Comparison of indicators related to pelvic plain film in children with ≤2 years old and normal children in the same age group,there was no statistical significance in AI,NSA and MP of the radiograph of the pelvis. Compared the normal pelvis in children with children with cerebral palsy in 2-3 years old,both NSA and MP had statistical significance while AI had no statistical significance. Compared the normal pelvis in children with CP children more than 3 years old,both NSA and MP had statistical significance while AI had no statistical significance. Conclusion Both NSA and MP are effective indicators to reflect secondary subluxation of the hip joint in children with cerebral palsy.
引文
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[12]廖元贵.脑瘫患儿髋关节脱位的系统管理[J].中国康复医学杂志,2008,23(6):570-3.
[13]黄晶晶,周云,吴建贤.脑瘫患儿继发性髋关节发育异常的X线检测方法[J].中国伤残医学,2016,24(24):97-9.
[2]李雪明,吴建贤. TNF-α在痉挛型脑瘫中的异常表达[J].安徽医科大学学报,2014,49(5):692-3,697.
[3] Ramstad K,Jahnsen R B,Terjesen T. Severe hip displacement reduces health-related quality of life in children with cerebral palsy[J]. Acta Orthop,2017,88(2):205-10.
[4]吴俊华,段振华,叶秀,等.安徽省7市2005~2009年病残儿流行病学调查[J].安徽医学,2011,32(6):813-6.
[5]黄晶晶,周云,吴建贤.脑瘫患儿髋关节脱位康复治疗的研究进展[J/CD].中华临床医师杂志(电子版),2014,8(19):3541-6.
[6]颜华,张惠佳,高雅君,等.痉挛型脑瘫患儿发生髋关节脱位风险的观察研究[J].中国儿童保健杂志,2010,18(9):697-9.
[7]许晶莉,黄少昂,叶长青,等.学龄期脑性瘫痪儿童髋关节发育与髋周肌肉状况的相关性分析[J].中国中西医结合儿科学,2016,8(1):88-90.
[8]黄晶晶,周云,阚秀丽,等.家庭髋关节姿势管理对痉挛型双瘫脑瘫儿童髋关节发育的影响:前瞻性随机对照研究[J].中国康复医学杂志,2017,32(9):1016-20.
[9] Wu J,Zhang J,Hong Y. Quality of life of primary caregivers of children with cerebral palsy:a comparison between mother and grandmother caregivers in Anhui province of China.[J]. Child Care Health Dev,2017,43(5):718-24.
[10] Pountney T E,Mandy A,Green E,et al. Hip subluxation and dislocation in cerebral palsy-a prospective study on the effectiveness of postural management programmes[J]. Physiother Res Int,2009,14(2):116-27.
[11]张发智.生物力学分析髋臼指数的临床意义[J].中国实用医药,2008,3(17):46-7.
[12]廖元贵.脑瘫患儿髋关节脱位的系统管理[J].中国康复医学杂志,2008,23(6):570-3.
[13]黄晶晶,周云,吴建贤.脑瘫患儿继发性髋关节发育异常的X线检测方法[J].中国伤残医学,2016,24(24):97-9.