Jones D A
Department of Children's Orthopaedic Surgery, School of Postgraduate Medical and Health Care Studies, Morriston Hospital, Swansea.
Ann R Coll Surg Engl. 1994 Jul;76(4):245-50.
The call for screening for an increasing number of surgical diseases is becoming louder and more frequent. There is a general perception that screening is 'good' but it is important to consider the evidence carefully. There is one surgical disease that provides considerable experience of the process of screening over a period of 30 years and this is congenital dislocation of the hip (CDH). In retrospect, it is clear that screening for this disease has not been a total success. Although some specialised centres have achieved excellent results, in the country as a whole screening has been a failure. The reasons for this are analysed and emphasis is placed on the principles of screening which are briefly summarised. The results of various studies on screening and experiments on the basic functional anatomy of the neonatal hip are described. The initial results of our method of selective ultrasound screening appear to be encouraging and some evidence of a possible collagen abnormality in CDH is presented. As a general principle, however, it is suggested that strict randomised controlled trials should take place before national screening programmes are started.
对越来越多外科疾病进行筛查的呼声越来越高，也越来越频繁。人们普遍认为筛查是“有益的”，但仔细考虑相关证据很重要。有一种外科疾病在30年的时间里提供了大量关于筛查过程的经验，这就是先天性髋关节脱位（CDH）。回顾过去，很明显对这种疾病的筛查并非完全成功。尽管一些专业中心取得了优异的成果，但在全国范围内筛查是失败的。分析了其中的原因，并强调了筛查的原则，这些原则将简要总结。描述了关于筛查的各种研究结果以及新生儿髋关节基本功能解剖的实验。我们的选择性超声筛查方法的初步结果似乎令人鼓舞，并提出了一些先天性髋关节脱位可能存在胶原蛋白异常的证据。然而，作为一般原则，建议在启动全国性筛查计划之前应进行严格的随机对照试验。
