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目的总结近期院内0~36个月的新生儿与婴儿髋关节发育不良(developmental dysplasia of the hip,DDH)筛查情况,形成规范的新生儿与婴儿DDH筛查流程。方法我院出生新生儿由产科医师进行DDH的初步筛查,儿内科0~36个月住院患儿及儿外科0~36个月的门诊就诊患者分别由儿科医师、儿外科医师进行DDH的初步筛查,可疑或异常者转诊至我院儿童骨科复筛,由儿童骨科医师对转诊儿童再次进行临床检查,并行双髋关节B超或者X线片进一步检查,可疑者定期复查直至确诊或排除。结果 2012年1月至2014年12月,共筛查婴幼儿22 396例,2699例行髋关节B超筛查,B超检查可疑和异常591例(755髋)转诊到儿童骨科。可疑患儿中61例(89髋)Ortolani或Barlow试验阳性,94例(131髋)骨盆正位X线片显示髋臼发育不良,最终76例(121髋)确诊为DDH。其中男21例(29髋),女55例(92髋);左91髋,右30髋;1~6个月13例(其中新生儿3例)1.95‰(13/6676),7~18个月49例7.09‰(49/6909),19~36个月14例1.59‰(14/8811),76例明确诊断DDH患儿中,7~18个月者49例,占64.47%;DDH的发病率为3.39‰(76/22 396)。结论本次筛查对象是0~36个月的新生儿与婴幼儿,这种筛查模式实现了对儿童DDH的早发现、早诊断,形成了符合本地区实际情况的规范筛查流程。
Objective To summarize the recent screenings of DDH in newborns and infants aged 0-36 months in the hospital and to establish a standardized DDH screening program for newborns and infants. Methods A neonatal newborn born in our hospital was initially screened by obstetricians for DDH. Pediatric physicians and pediatric surgeons conducted initial DDH for pediatric patients and pediatric patients with 0-36 months of 0-36 months of outpatient visits. Screening, suspicious or abnormal referral to our hospital children orthopedic re-screening by the pediatric orthopedic clinic for referral of children once again, parallel double hip or B-X-ray examination, suspects regular review until the diagnosis or exclude. Results From January 2012 to December 2014, 22 396 infants and toddlers were enrolled in this study. B-ultrasonography was performed in 2699 patients with suspicious and abnormal B-ultrasound, and 591 patients (755 hips) were referred to pediatric orthopedics. Of the suspicious children, 61 (89 hips) were positive for Ortolani or Barlow, and 94 (131 hips) pelvic radiographs showed acetabular dysplasia and eventually 76 (121 hips) were diagnosed with DDH. Among them, there were 21 males (29 hips) and 55 females (92 hips), 91 left and right 30 hips, and 1.95 ‰ (13/6676) and 7-18 males There were 49 cases (64.47%) of 49 cases (49/6909) in 49 months, 14 cases (1.59%) in 14 cases (19/36 months), 76 cases diagnosed DDH in 7 ~ 18 months The incidence was 3.39 ‰ (76/22 396). Conclusion The screening target is 0 to 36 months of newborns and infants and young children. This screening model has enabled the early detection and early diagnosis of DDH in children, and has formed a standardized screening procedure in line with the actual situation in the region.