CAJ | 학술논문

目的探讨Graf法髋关节超声诊断在婴儿发育性髋关节异常(DDH)筛查和随访中的作用.方法对662名6月龄以内婴儿(1324髋)行Graf法髋关节超声筛查.通过观察骨性髋臼、骨性髋臼外侧缘、软骨性髋臼形态及测量α角、β角,对髋关节进行Graf分型.对性别、侧别、胎位、襁褓方式等DDH发病影响因素进行评价.对需要跟踪观察或治疗的发育不成熟、发育不良及脱位病例进行超声随访.结果本组选择性超声筛查DDH的检出率为7.42%.性别、妊娠胎位是DDH发病的影响因素.27例发育不良与5例髋关节脱位在治疗中接受了超声随访,13例发育不良病例经外展操锻炼超声指标达到正常,14例因改善不明显接受Pavlik吊带治疗,5例脱位经Pavlik吊带治疗无效而接受闭合复位加外固定手术治疗.结论超声检查能对婴儿髋关节发育情况进行客观评估,监测DDH治疗过程并指导临床治疗方案,可作为婴儿DDH早期筛查与随访的主要手段.
목적 탐토Graf법관관절초성진단재영인발육성관관절이상(DDH)사사화수방중적작용.방법 대662명6월령이내영인(1324관)행Graf법관관절초성사사.통과관찰골성관구、골성관구외측연、연골성관구형태급측량α각、β각,대관관절진행Graf분형.대성별、측별、태위、강보방식등DDH발병영향인소진행평개.대수요근종관찰혹치료적발육불성숙、발육불량급탈위병례진행초성수방.결과 본조선택성초성사사DDH적검출솔위7.42%.성별、임신태위시DDH발병적영향인소.27례발육불량여5례관관절탈위재치료중접수료초성수방,13례발육불량병례경외전조단련초성지표체도정상,14례인개선불명현접수Pavlik조대치료,5례탈위경Pavlik조대치료무효이접수폐합복위가외고정수술치료.결론 초성검사능대영인관관절발육정황진행객관평고,감측DDH치료과정병지도림상치료방안,가작위영인DDH조기사사여수방적주요수단.
Objective To assess the role of hip ultrasonography in the early screening and following up of developmental dysplasia of the hip (DDH). Methods A total of 1324 hips of 662 infants younger than 6 months underwent ultrasonography with Graf method. The sonographic appearances of bony roof, superior bony rim, cartilaginous roof, as well as α and β angle measurements were classified according to the Graf method. Risk factors such as gender, sides, fetal position, and swaddling used were assessed. Following up were performed with ultrasonography in the cases of immaturity, dysplasia and dislocation that needed to be monitored or treated. Results Detection rate of selective ultrasound in screening of DDH of the hip was 7.42%. Both gender and fetal position was the risk factor of DDH. Twenty-seven infants with dysplasia hip and five with dislocation hip were followed-up with ultrasonography during treatment process. Thirteen infants with dysplasia turned to normal after abduction exercises, while other fourteen received treatment in Pavlik harness for no improvement in ultrasonography. All infants of dislocation received operation eventually because of failing to Pavlik harness. Conclusion Ultrasonography can objectively assess the development of DDH, monitor the course of following-up and treatment of DDH, and serve as a main tool in the early screening and following up of DDH in infants.