中华外科杂志
中華外科雜誌
중화외과잡지
CHINESE JOURNAL OF SURGERY
2009年
13期
1017-1019
,共3页
髋脱位,先天性%治疗,临床研究性%闭合复位
髖脫位,先天性%治療,臨床研究性%閉閤複位
관탈위,선천성%치료,림상연구성%폐합복위
Hip dislocation,congenital%Therapies,investigational%Closed reduction
目的 研究闭合复位术治疗发育性髋脱位(developmental dysplasia of the hip,DDH)的长期随访结果,分析复位后影响结果满意度的相关因素.方法 对1997至2005年发育性髋脱位闭合复位后60例患者(共77髋)进行平均4.5年的随访,总结临床记录和影像学资料,统计分析影响结果满意度的相关因素.结果 应用Sevefin影像学分级,77髋中56髋(73%)结果满意,Severin分级为Ⅰ～Ⅱ级;21髋结果为Severin Ⅲ～Ⅵ级,其中17髋行二次复位或矫形手术.29髋(38%)发生了程度不同的缺血坏死.统计影响结果满意度的相关因素发现:复位时年龄是影响结果满意度的重要因素(P＜0.05),复位时年龄越小最后结果的满意度越高;股骨头缺血坏死也和结果满意度相关(P＜0.05).结论 婴幼儿发育性髋脱位应早期治疗,以提高结果优良率.
目的 研究閉閤複位術治療髮育性髖脫位(developmental dysplasia of the hip,DDH)的長期隨訪結果,分析複位後影響結果滿意度的相關因素.方法 對1997至2005年髮育性髖脫位閉閤複位後60例患者(共77髖)進行平均4.5年的隨訪,總結臨床記錄和影像學資料,統計分析影響結果滿意度的相關因素.結果 應用Sevefin影像學分級,77髖中56髖(73%)結果滿意,Severin分級為Ⅰ～Ⅱ級;21髖結果為Severin Ⅲ～Ⅵ級,其中17髖行二次複位或矯形手術.29髖(38%)髮生瞭程度不同的缺血壞死.統計影響結果滿意度的相關因素髮現:複位時年齡是影響結果滿意度的重要因素(P＜0.05),複位時年齡越小最後結果的滿意度越高;股骨頭缺血壞死也和結果滿意度相關(P＜0.05).結論 嬰幼兒髮育性髖脫位應早期治療,以提高結果優良率.
목적 연구폐합복위술치료발육성관탈위(developmental dysplasia of the hip,DDH)적장기수방결과,분석복위후영향결과만의도적상관인소.방법 대1997지2005년발육성관탈위폐합복위후60례환자(공77관)진행평균4.5년적수방,총결림상기록화영상학자료,통계분석영향결과만의도적상관인소.결과 응용Sevefin영상학분급,77관중56관(73%)결과만의,Severin분급위Ⅰ～Ⅱ급;21관결과위Severin Ⅲ～Ⅵ급,기중17관행이차복위혹교형수술.29관(38%)발생료정도불동적결혈배사.통계영향결과만의도적상관인소발현:복위시년령시영향결과만의도적중요인소(P＜0.05),복위시년령월소최후결과적만의도월고;고골두결혈배사야화결과만의도상관(P＜0.05).결론 영유인발육성관탈위응조기치료,이제고결과우량솔.
Objectives To retrospectively review the results of closed reduction for developmental dysplasia of the hip (DDH), and analyze the causative for the dissatisfactory results of radiolagieal. Methods From 1997 to 2005 the results of closed reduction for DDH in 60 children (77 hips) over 4.5 years period were retrospectively reviewed. Radiological final results of the patients were evaluated with Severin classification. The causative factors made from medical records and radiographs were used to make statistical analysis. Results Seventy-three percent of the patients (56/77) had satisfactory results according to Severin classification. Twenty-one hips classed as SeverinⅢ-Ⅴ. Seventeen of the 21 hips had a reconstructive procedure. Avaseular necrosis was observed in 29 hips (38%). The most important parameters affecting the result were age at reduction (P ＜ 0. 05) and avascular necrosis (P ＜ 0.05).Conclusions In order to achieve better clinical and radioiogical results, the infants suffering from the DDH should be treated in the early stage. The postoperative avascular necrosis usually leads to poor prohnosis.
