作　　者： (）;

机构地区： 广东医科大学

出　　处： 《广州医科大学学报》 2019年第2期40-43,共4页

摘　　要： 目的:探讨超声Graf法联合Harcke法、Terjesen法对婴幼儿发育性髋关节发育不良(DDH)的全方位筛查和治疗评估价值。方法:选取2018年1月至2019年1月在广东医科大学顺德妇女儿童医院进行体检的150例出生6个月内疑似DDH患儿作为研究对象,随机数字表法分为对照组(n=75)和试验组(n=75),对照组采用超声Graf法,试验组联合采用超声Graf法、Harcke法、Terjesen法。以X线片检查结果作为'金标准',对比两组诊断敏感性、特异性及准确度,对检查结果异常患儿施行干预治疗。结果:对照组X线片检查显示DDH阳性19例,超声Graf法检出DDH阳性15例。试验组X线片检查显示DDH阳性20例,三法联合检出DDH阳性20例。试验组诊断DDH的敏感性(100.00%)和准确度(100.00%)均高于对照组(73.68%、92.00%),差异均有统计学意义(均P<0.05)。39例DDH阳性患儿共有患病髋关节57个,初次超声检查Ⅰ型髋关节25个、Ⅱa型和Ⅱb型髋关节22个、Ⅱc型髋关节4个、D型髋关节3个、Ⅲ型髋关节2个、Ⅳ型髋关节1个;随访结束后行Graf法、Harcke法、Terjesen法联合复查,18个Ⅱa型和Ⅱb型髋关节转为Ⅰ型,Ⅱc型、D型、Ⅲ型、Ⅳ型髋关节经相应干预、治疗后,4个转为Ⅰ型,3个转为Ⅱb型,2个转为Ⅱc型,1个转为D型。结论:超声Graf法联合Harcke法、Terjesen法能显著提高DDH诊断的敏感性和准确度,有效降低漏诊率,且能动态监测DDH患儿髋关节发育情况,在DDH患儿全方位筛查和治疗评估中具有较高应用价值。 Objective:To investigate the value of ultrasound study with combined use of Graf,Harcke and Terjesen approaches in screening and treatment evaluation of developmental dysplasia of the hip(DDH)in infants.Methods:A total of 150 infants at6 month after birth with suspected DDH in our hospital were enrolled and randomly divided into the control group(n=75)and the study group(n=75).The control group was examined via Graf approach alone,and the study group via combined use of Graf,Harcke and Terjesen approaches.Using X ray imaging diagnosis as the gold standard,the sensitivity,specificity and accuracy of diagnosis in the two groups were compared.Infants with abnormal findings were intervened accordingly.Results:In the control group,DDH was identified by X-ray imaging in 19 infants and by ultrasound with Graf approach in15 infants.In the study group,DDH was identified by X-ray imaging in 20 infants and by ultrasound with three approaches combined in 20 infants.The sensitivity(100.00%)and accuracy(100.00%)for DDH diagnosis in the study group were higher than those in the control group(73.68%and 92.00%),with statistical differences between groups(all P<0.05).Among 39 DDH infants,57 hip joints were affected.By initial ultrasound examination,DDH was type I in25 hip joints,types IIa and IIb in22,type IIc in4,type D in3,type III in 2,and type IV in 1 hip joint.In the ultrasound follow-up with combined use of Graf,Harcke and Terjesen approaches,18 type IIa or IIb hip joints had been converted into type I;of the types IIc,D,III,and IV hip joints,4 were converted to type I,3 to type IIb,and 2 to type IIc,and one to type D hip joint,as a result of treatment interventions.Conclusion:Ultrasound examination with combined use of Graf,Harcke and Terjesen approaches may significantly improve the sensitivity and accuracy of DDH diagnosis,effectively reduce the rate of missed diagnosis,and dynamically monitor the hip joints in DDH children,and is therefore of importance in comprehensive screening and treatment of DDH in children.

关 键 词： 发育性髋关节发育不良 超声检查 法 法 法

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