CAJ | 학술논문

目的探讨Penhes病人手术前临床资料及影像学特征与预后的关系.方法对1999年1月至2012年12月北京积水潭医院小儿骨科收治的144例Perthes病例进行回顾性分析.收集病人年龄、性别、随访时间、侧别、术前及术后X线片等临床资料,以Stulberg分型为评估标准,对预后进行相关分析研究.结果男女比例8.6:1,发病年龄(8.1±2.0)(3～14)岁,随访时间(5.9±2.3)(3 ～13)年.Stulberg Ⅰ和Ⅱ型52例(36.1％),Ⅲ型57例(39.6％),Ⅳ和Ⅴ型35例(24.3％).低年龄组(≤8岁)与高年龄组(＞8岁)之间,外侧柱分级(A,B,C级)之间,Catterall分期(A,B组)之间,Stulberg分型结果差异均有统计学意义(均P＜0.01).多分类Logistic回归分析显示,年龄、外侧柱分级、外侧半脱位是影响预后的独立危险因素.结论发病年龄,外侧柱分级,外侧半脱位是影响Perthes病预后的相关因素；发病年龄越大,外侧柱分级越高,术前出现外侧半脱位预示着不良的预后.
목적 탐토Penhes병인수술전림상자료급영상학특정여예후적관계.방법 대1999년1월지2012년12월북경적수담의원소인골과수치적144례Perthes병례진행회고성분석.수집병인년령、성별、수방시간、측별、술전급술후X선편등림상자료,이Stulberg분형위평고표준,대예후진행상관분석연구.결과 남녀비례8.6:1,발병년령(8.1±2.0)(3～14)세,수방시간(5.9±2.3)(3 ～13)년.Stulberg Ⅰ화Ⅱ형52례(36.1％),Ⅲ형57례(39.6％),Ⅳ화Ⅴ형35례(24.3％).저년령조(≤8세)여고년령조(＞8세)지간,외측주분급(A,B,C급)지간,Catterall분기(A,B조)지간,Stulberg분형결과차이균유통계학의의(균P＜0.01).다분류Logistic회귀분석현시,년령、외측주분급、외측반탈위시영향예후적독립위험인소.결론 발병년령,외측주분급,외측반탈위시영향Perthes병예후적상관인소；발병년령월대,외측주분급월고,술전출현외측반탈위예시착불량적예후.
Objective To determine the prognostic factors and outcomes of Legg-Calvé-Perthes (LCP) disease.Methods A retrospective review was conducted for a total of 144 LCP patients at Department of Pediatric Orthopedics,Beijing Jishuitan Hospital.Their clinical data,such as age,gender,follow-up duration and radiological characteristics,were collected and assessed with Stulberg classification scheme.Results The male-to-female ratio was 8.6:1.Their age of onset was 8.06 ± 2.01 years and follow-up period 5.90 ± 2.29 years.There were Stulberg Ⅰ and Ⅱ (n =52,36.1％),Ⅲ type (n =57,39.6％) and Ⅳ and Ⅴ type (n =35,24.3％).Between the low-age (≤8) and high-age (＞8) groups,the results of lateral pillar classification (A,B,C),modified Catterall staging (A,B) and Stulberg classification had significant differences (P ＜ 0.005).Logistic regression analysis showed that age,lateral pillar classification and lateral half dislocation were independent prognostic risk factors.Conclusion Age,lateral pillar classification and lateral half dislocation are prognostic factors for LCP.And greater age and higher lateral pillar classification denote a worse outcome.