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目的探讨儿童急性髋关节一过性滑膜炎(transient synovitis of the hip,TSH)的临床分期及疗效评价。方法回顾分析2002年1月-2009年12月收治的1021例单侧急性TSH患儿,其中男804例,女217例;年龄2～12岁。根据病程、临床症状和体征、影像学检查进行临床分期,共分为Ⅰ～Ⅳ4期。其中Ⅰ期199例,Ⅱ期334例,Ⅲ期467例,Ⅳ期21例。根据不同的临床分期,采用制动、牵引、局部理疗及药物等方法进行治疗。结果 1021例获随访6个月～8年。治疗后1002例患儿的临床症状和体征消失,髋关节功能完全恢复正常,无并发症。15例反复发作者根据不同的临床分期进行相应的治疗。4例发展为Perthes病者行手术治疗。结论 TSH临床分期有助于对病情正确判断,指导临床治疗,促进髋关节功能恢复。及时恰当治疗可避免病程迁延、恶化,改善预后。
Objective To investigate the clinical staging and therapeutic evaluation of acute synovitis of the hip (TSH) in children. Methods A total of 1021 unilateral acute TSH children admitted from January 2002 to December 2009 were retrospectively analyzed. There were 804 males and 217 females, aged 2 to 12 years old. According to the course of disease, clinical symptoms and signs, imaging examination for clinical staging, is divided into Ⅰ ~ Ⅳ4. There were 199 cases of stage Ⅰ, 334 cases of stage Ⅱ, 467 cases of stage Ⅲ and 21 cases of stage Ⅳ. According to different clinical stages, the use of braking, traction, local physical therapy and drugs and other methods of treatment. Results 1021 cases were followed up for 6 months to 8 years. After treatment, the clinical symptoms and signs of 1002 children disappeared, and the function of hip joint completely returned to normal with no complications. 15 cases of repeat authors according to different clinical stages of the corresponding treatment. Four patients developed Perthes disease undergoing surgical treatment. Conclusion The clinical staging of TSH can help to judge the condition correctly, guide the clinical treatment and promote the recovery of hip joint function. Proper and timely treatment can avoid prolonged course, worsening, improve prognosis.