[出生后6个月内进行的先天性髋关节发育不良骨科治疗的超声监测]

[Ultrasound monitoring of the orthopaedic treatment of congenital hip dysplasia carried out within the first 6 months of life].

作者信息

Azzoni R, Cabitza P

机构信息

Clinica Ortopedica, Istituto di Scienze Medico-Chirurgiche San Donato, Università degli Studi di Milano, Istituto Policlinico San Donato, San Donato Milanese (MI), Italy.

出版信息

Minerva Pediatr. 2003 Apr;55(2):143-8.

PMID:12754458

Abstract

BACKGROUND

The use of ultrasound scanning in the early diagnosis of congenital hip dysplasia in infants within the first six months of life has become part of the routine in preventive medicine examinations. Ultrasound scanning makes it possible to monitor the development of the neonatal dysplasic hip at any moment and it also tells us whether or not it is responding to treatment and, if it is not, to modify the treatment in order to achieve cure.

METHODS

The present study considers pathological hips studied echographically over 12 years in order to assess to what extent ultrasound controls during treatment have influenced the choices and modifications of treatment. The study employed different echographic equipment always with 5 or 7.5 MHz linear probes; the evaluation technique employed was that proposed by Graf. Echography evaluation was always proceded by clinical assessment and followed at the end of treatment by X-ray control of the pelvis.

RESULTS

Of 17,938 hip cases assessed echographically from 1 January 1989 to 31 December 2000 (59.5% female and 40.5% male, average age 3 months 17 days) 1534 hips were pathological (IIC, IID, IIIA, IIIB); the prevalence of the condition in females and on the left-hand side was confirmed. In 35 cases (2.19%) the orthopaedic treatment approach undertaken at the beginning was changed on the basis of periodic scans. The normalisation of the alpha angle was achieved on average in 51 days of treatment with the harness; with a minimum time of 30 days in IIC type hips in patients below the age of three months and a maximum time of 98 days in hips of type IIIA in patients aged more than 120 days.

CONCLUSIONS

The simplicity and ease of use of ultrasound scanning, its cheapness, rapidity, harmlessness and validity not to mention its sensitivity and specificity make it a reliable, safe instrumental examination that is indispensable in planning the treatment of this pathology.

摘要

背景

在出生后前六个月对婴儿先天性髋关节发育不良进行超声扫描早期诊断，已成为预防医学检查的常规内容。超声扫描能够随时监测新生儿发育不良髋关节的情况，还能告知我们其对治疗是否有反应，若没有反应，则调整治疗方案以实现治愈。

方法

本研究对12年间通过超声检查的病理性髋关节进行分析，以评估治疗期间的超声检查在多大程度上影响了治疗方案的选择和调整。研究使用了不同的超声设备，均配备5或7.5MHz线性探头；采用的评估技术是格拉夫提出的。超声评估前总会先进行临床评估，治疗结束后通过骨盆X线检查进行随访。

结果

1989年1月1日至2000年12月31日期间，共对17938例髋关节进行了超声评估（女性占59.5%，男性占40.5%，平均年龄3个月17天），其中1534例髋关节为病理性（IIC、IID、IIIA、IIIB）；证实了该病在女性和左侧的患病率。35例（2.19%）患者最初采用的骨科治疗方法根据定期扫描结果进行了改变。使用吊带治疗平均51天可使α角恢复正常；3个月以下IIC型髋关节患者最短30天，120天以上IIIA型髋关节患者最长98天。