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目的探讨Graf超声检查法在婴儿发育性髋关节发育不良(DDH)筛查及随访中的实际应用价值。方法对北京地区基层妇幼保健机构体检筛查可疑婴儿DDH转我院诊治,行Graf法髋关节超声检查,受检婴儿年龄为1~180d,阳性髋关节超声随访至婴儿月龄达180d,阳性髋关节为GrafⅡa、Ⅱb、Ⅱc、D、Ⅲ、Ⅳ型。结果受检婴儿共计13 455例(26 910髋),首诊行Graf法的平均年龄为69.0d。受检婴儿首次髋关节I型髋关节24 957个(92.74%);Ⅱa型髋关节1 338个(4.97%);Ⅱb型髋关节409个(1.52%);Ⅱc型髋关节97个(0.36%);D型髋关节8个(0.03%);Ⅲ型髋关节52个(0.19%);Ⅳ型髋关节49个(0.18%)。首次就诊非Graf I型髋关节完成随访复查共1 705髋,超声随访期内首诊GrafⅡa型和D型髋关节无1例加重,Ⅱb型仅2例加重;Ⅱc型仅2例加重;Ⅲ型仅1例加重。结论 Graf法在婴儿DDH筛查及随访中具有重要应用价值。
Objective To investigate the value of Graf ultrasonography in screening and follow-up of developing hip dysplasia (DDH) in infancy. Methods DDH was performed in the hospital for maternal and child health checkup screening in Beijing. The Graf method was used to diagnose and treat hip dysplasia. The age of infants was from 1 to 180 days, and the positive hip ultrasound was followed up to 180 days of age. The positive hip Joints Graf Ⅱ a, Ⅱ b, Ⅱ c, D, Ⅲ, Ⅳ type. Results The total number of infants tested was 13,455 (26,910 hips). The mean age of first graders was 69.0 days. There were 24,957 (92.74%) first hip joints of type I infants, 1 338 (4.97%) of type IIa hip joints, 409 (1.52%) of type IIb hip joints, 97 (0.36% ); 8 hip joints (0.03%); 52 hip joints (0.19%); 49 hip joints (0.18%). The first visit of non-Graf type I hip was completed and followed up for a total of 1 705 hips. During the follow-up period of ultrasonic follow-up, there was no increase of GrafⅡa and D type hip in the first visit, only 2 cases of type Ⅱb increased, only 2 cases of type Ⅱc exacerbated, Only one case aggravated. Conclusion Graf method has important application value in the screening and follow-up of DDH in infants.