5227例婴儿发育性髋关节发育异常筛查结果的回顾性分析
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摘要
目的 :评估产次、胎位、分娩方式对婴儿发育性髋关节发育异常(DDH)发病的影响。方法 :回顾性分析于我院行DDH超声筛查婴儿5 227例(10 454个髋关节),记录其性别、年龄、胎次、胎位、分娩方式,依据Graf分类法将超声筛查结果分为正常和异常髋关节(发育不良、半脱位、脱位),并行统计分析。结果:5 227例,共10 454个髋关节,其中第1胎DDH的检出率为4.47%(284/6 350)高于第2胎(3.05%,125/4 104)(χ~2=15.08,P<0.01);臀位DDH检出率9.05%(42/464)较头位(3.67%,366/9 968)明显高(χ~2=34.15,P<0.01);剖宫产DDH检出率5.33%(196/3 678)高于自然分娩(3.14%,213/6 776)(χ~2=27.51,P<0.01)。结论 :产次、胎位、分娩方式均是影响DDH的因素,而臀位的影响更显著,可提示DDH的超声筛查。
Objective:To explore the influence of parity,position of the fetus and method of delivery on developmental dysplasia of the hip(DDH) for infants. Methods:A retrospective analysis on 5,227 infants(10,454 hips) DDH were underwent by ultrasonic screening,and their sex,age,parity,position of the fetus,method of delivery and ultrasonic screening results were noted down. The ultrasonic results were divided into normal and abnormal hips(dysplasia,subluxation,luxation) according to Graf's method. The data were analyzed statistically. Results:The detect rate of DDH in first-born with 4.5%(284/6350),was higher than second fetus 3.05%(125/4104)(χ~2=15.08,P< 0.01). The detect rate of DDH in breech position with 9.05%(42/464),was higher than head position with 3.67%(366/9968) obviously. The detect rate of DDH in cesarean with 5.33%(196/3678),was higher than in natural labor with 3.14%(213/6776)(χ~2=27.51,P< 0.01). Conclusion:DDH is affected by parity,position of the fetus,method of delivery,and DDH is affected by breech position remarkably,which provide a guidance to DDH ultrasonic screening.
Objective:To explore the influence of parity,position of the fetus and method of delivery on developmental dysplasia of the hip(DDH) for infants. Methods:A retrospective analysis on 5,227 infants(10,454 hips) DDH were underwent by ultrasonic screening,and their sex,age,parity,position of the fetus,method of delivery and ultrasonic screening results were noted down. The ultrasonic results were divided into normal and abnormal hips(dysplasia,subluxation,luxation) according to Graf's method. The data were analyzed statistically. Results:The detect rate of DDH in first-born with 4.5%(284/6350),was higher than second fetus 3.05%(125/4104)(χ~2=15.08,P< 0.01). The detect rate of DDH in breech position with 9.05%(42/464),was higher than head position with 3.67%(366/9968) obviously. The detect rate of DDH in cesarean with 5.33%(196/3678),was higher than in natural labor with 3.14%(213/6776)(χ~2=27.51,P< 0.01). Conclusion:DDH is affected by parity,position of the fetus,method of delivery,and DDH is affected by breech position remarkably,which provide a guidance to DDH ultrasonic screening.
引文
[1]Rosenberg N,Bialik V,Norman D,et al.The importance of combined clinical and sonographic examination of instability of the neonatal hip[J].Int Orthop,1998,22:185-188.
[2]陈博昌,吴守义,沈晓明.发育性髋关节异常的超声波检查[J].临床小儿外科杂志,2003,2(3):196-200.
[3]Bialik V,Berant M.“Immunity”of Ethiopian Jews to developmental dysplasia of the hip:a preliminary sonographic study[J].J Pediatr Orthop B,1997,6:253-254.
[4]Graf R,赵黎.婴幼儿髋关节超声波检查的方法和原理[M].西安:第四军医大学出版社,2011:44.
[5]张娜,陈雪辉,王连英.婴幼儿发育性髋关节不良的超声筛查——130例婴幼儿筛查分析[J].中国妇幼健康研究,2016,27(3):376-378.
[6]中华医学会骨科学分会.发育性髋关节发育不良诊疗指南(2009)[J].中国矫形外科杂志,2013,21(9):953-954.
[7]翟大明,赵奕文,杨少玲,等.超声对婴儿期发育性髋关节异常的筛查作用[J].临床超声医学杂志,2014,16(1):61-63.
[8]孙国强.实用儿科放射诊断学[M].2版.北京:人民军医出版社,2011:709-711.
[9]陈博昌,杨杰,吴虹,等.新生儿髋关节发育性异常的超声波筛查[J].中华小儿外科杂志,2007,28(11):590-593.
[10]李功祥,程幸,林小影.超声筛查发育性髋关节发育不良高危婴儿的临床价值[J].临床超声医学杂志,2016,18(12):845-847.
[11]王双燕,邹旭彤,卞咏梅,等.新生儿髋关节筛查资料分析[J].中国新生儿科杂志,2014,29(3):162-166.
[12]Kosar P,Ergun E,Gokharman FD,et al.Follow-up sonographic results for Graf type 2A hips:association with risk factors for developmental dysplasia of the hip and instability[J].J Ultrasound Med,2011,30:677-683.
[13]Nemeth BA,Narotam V.Developmental dysplasia of the hip[J].Pediatr Rev,2012,33:553-561.
[14]Quan T,Kent AL,Carlisle H.Breech preterm infants are at risk of developmental dysplasia of the hip[J].J Paediatr Child Health,2013,49:658-663.
[15]薛远亮,刘斌,王世山.发育性髋关节脱位的影像学研究[J].中国中西医结合影像学杂志,2007,5(4):290-293.
[16]李功祥,程幸,林小影,等.超声评价异常体征合并发育性髋关节发育不良高危因素婴儿的髋关节发育状况[J].中国中西医结合影像学杂志,2016,14(5):540-542.
[17]彭明惺,刘利君,周锡华,等.先天性髋关节脱位病因探讨(附706例遗传流行病学调查)[J].华西医学,1996,11(1):91.
[2]陈博昌,吴守义,沈晓明.发育性髋关节异常的超声波检查[J].临床小儿外科杂志,2003,2(3):196-200.
[3]Bialik V,Berant M.“Immunity”of Ethiopian Jews to developmental dysplasia of the hip:a preliminary sonographic study[J].J Pediatr Orthop B,1997,6:253-254.
[4]Graf R,赵黎.婴幼儿髋关节超声波检查的方法和原理[M].西安:第四军医大学出版社,2011:44.
[5]张娜,陈雪辉,王连英.婴幼儿发育性髋关节不良的超声筛查——130例婴幼儿筛查分析[J].中国妇幼健康研究,2016,27(3):376-378.
[6]中华医学会骨科学分会.发育性髋关节发育不良诊疗指南(2009)[J].中国矫形外科杂志,2013,21(9):953-954.
[7]翟大明,赵奕文,杨少玲,等.超声对婴儿期发育性髋关节异常的筛查作用[J].临床超声医学杂志,2014,16(1):61-63.
[8]孙国强.实用儿科放射诊断学[M].2版.北京:人民军医出版社,2011:709-711.
[9]陈博昌,杨杰,吴虹,等.新生儿髋关节发育性异常的超声波筛查[J].中华小儿外科杂志,2007,28(11):590-593.
[10]李功祥,程幸,林小影.超声筛查发育性髋关节发育不良高危婴儿的临床价值[J].临床超声医学杂志,2016,18(12):845-847.
[11]王双燕,邹旭彤,卞咏梅,等.新生儿髋关节筛查资料分析[J].中国新生儿科杂志,2014,29(3):162-166.
[12]Kosar P,Ergun E,Gokharman FD,et al.Follow-up sonographic results for Graf type 2A hips:association with risk factors for developmental dysplasia of the hip and instability[J].J Ultrasound Med,2011,30:677-683.
[13]Nemeth BA,Narotam V.Developmental dysplasia of the hip[J].Pediatr Rev,2012,33:553-561.
[14]Quan T,Kent AL,Carlisle H.Breech preterm infants are at risk of developmental dysplasia of the hip[J].J Paediatr Child Health,2013,49:658-663.
[15]薛远亮,刘斌,王世山.发育性髋关节脱位的影像学研究[J].中国中西医结合影像学杂志,2007,5(4):290-293.
[16]李功祥,程幸,林小影,等.超声评价异常体征合并发育性髋关节发育不良高危因素婴儿的髋关节发育状况[J].中国中西医结合影像学杂志,2016,14(5):540-542.
[17]彭明惺,刘利君,周锡华,等.先天性髋关节脱位病因探讨(附706例遗传流行病学调查)[J].华西医学,1996,11(1):91.