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风险因素评估及对婴幼儿人群行发育性髋关节脱位筛查的十年经验。

Risk Factor Assessment and a Ten-Year Experience of DDH Screening in a Well-Child Population.

机构信息

MD, Ph.D. Pediatrician, Istanbul University Institute of Child Health, Department of Social Pediatrics, Istanbul, Turkey.

MD, Pediatrician, Istanbul University Institute of Child Health, Department of Social Pediatrics, Istanbul, Turkey.

出版信息

Biomed Res Int. 2019 Aug 4;2019:7213681. doi: 10.1155/2019/7213681. eCollection 2019.

Abstract

AIM

Risk based screening for developmental dysplasia of the hip (DDH) with ultrasound is common. However, risk factors vary from one country to the other since data are insufficient to give clear recommendations. We aimed to evaluate the risk factors for developmental dysplasia of the hip (DDH).

METHODS

In this retrospective case-control study, the health records of all children, who were followed up between 2004 and 2014 at a well-child unit, were investigated for the diagnosis of DDH in Turkey. Of 9758 children, 57 children were found to have abnormal ultrasonographic findings (according to Graf classification) and these constituted the case group. As the control group, healthy 228 children who matched the case children in birth months were selected. Two groups were compared for the risk factors.

RESULTS

A total of 19516 hips of 9758 children were examined for DDH. 97 hips of 57 children were found to have abnormal ultrasonographic findings. When the two groups were compared, breech presentation, multiple pregnancy, and torticollis were identified as risk factors. The female sex was also found to have a significantly high prevalence among the children in the case group. Limited hip abduction, positive Ortolani, and Barlow signs were important clinical findings in the case group.

CONCLUSION

According to our findings, breech presentation, female sex, torticollis, and multiple pregnancy were found to be the risk factors of this disorder. Infants with these risk factors should be investigated carefully for DDH.

摘要

目的

对发育性髋关节发育不良(DDH)进行基于风险的超声筛查较为常见。然而,由于数据不足,无法给出明确的建议,因此各国的风险因素存在差异。本研究旨在评估发育性髋关节发育不良(DDH)的风险因素。

方法

本回顾性病例对照研究调查了 2004 年至 2014 年期间在土耳其一家儿童保健门诊接受随访的 9758 例儿童的健康记录,以诊断 DDH。在 9758 例儿童中,有 57 例儿童的超声检查结果异常(根据 Graf 分类),这些儿童构成了病例组。作为对照组,选择了与病例儿童出生月份相匹配的 228 名健康儿童。比较两组的风险因素。

结果

对 9758 例儿童的 19516 髋进行了 DDH 检查。57 例儿童中有 97 髋的超声检查结果异常。两组比较时,臀位、多胎妊娠和斜颈被确定为危险因素。病例组中女性儿童的比例也明显较高。在病例组中,髋关节外展受限、奥尔托兰尼(Ortolani)征阳性和巴罗(Barlow)征阳性是重要的临床发现。

结论

根据我们的研究结果,臀位、女性、斜颈和多胎妊娠被认为是该疾病的危险因素。具有这些危险因素的婴儿应仔细检查 DDH。

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