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[新生儿筛查中髋关节随访临床检查结果的恶化]

[Deterioration of clinical findings in hip joint follow-ups in neonatal screening].

作者信息

Riebel T, Nasir R, Käding M, Eckart L

机构信息

Bereich Pädiatrische Radiologie, Universitätsklinikum Rudolf Virchow, Standort Wedding, Freie Universität Berlin.

出版信息

Monatsschr Kinderheilkd. 1990 Oct;138(10):664-9.

PMID:2079942
Abstract

6 per cent out of 4290 hips checked by neonatal ultrasound screening could be reexamined later on. 7 of 200 hips (i.e. 4 per cent), primarily categorized as type IIa, showed an unexpected severe deterioration to type D (n = 3) or even to type IIIa (n = 4) after a mean-time of 9 weeks. Additional 5 cases with similar unfavourable courses from IIa to IIc, D or IIIa, and even 3 initially normal hips, changing to type IIa, were seen in another screening material (not yet systematically analyzed). Reasons for possible initial misinterpretation (purely visual evaluation in most cases, uncertainties in measuring suboptimal sonographic cuts, deficiencies in technical equipment and documentation), equivocal classification of border-line sonograms as well as possible influence of additional risk factors are discussed. Routine sonographic re-examinations after 6 (to 12) weeks are recommended as obligatory for all hips.

摘要

在接受新生儿超声筛查的4290个髋关节中,6%的髋关节可在之后进行复查。在最初归类为IIa型的200个髋关节中,有7个(即4%)在平均9周后出现意外的严重恶化,转变为D型(n = 3)甚至IIIa型(n = 4)。在另一组筛查资料中(尚未进行系统分析),还发现另外5例有类似的从IIa型向IIc型、D型或IIIa型的不良病程,甚至有3个最初正常的髋关节转变为IIa型。文中讨论了可能导致最初误诊的原因(大多数情况下为单纯的视觉评估、次优超声切面测量的不确定性、技术设备和记录方面的缺陷)、边界超声图像的模糊分类以及其他风险因素可能产生的影响。建议对所有髋关节在6(至12)周后进行常规超声复查。

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