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目的了解四川阿坝大骨节病区儿童手部X线特点,观察其X线异常改变在生长发育过程中的转归,探索儿童大骨节病的干预方法。方法选择四川阿坝壤塘县南木达、茸木达及尕多乡异地育人学校4~14岁儿童110例进行调查;然后每年给予补充维生素、矿物质及微量元素6个月,共2年。研究前后分别拍摄儿童双手X线片,并由副高以上高年资骨科医师进行体格检查。结果没有药物不良反应,失访3例,2年后仍处于骨骺等径期前的儿童98例。2年后,儿童双手示、中指末节屈曲者从7例降至1例,发现锥形骨骺者从13例降至7例,13例示、中、环指近、中节单发异常改变者中5例未检出异常,另有新发2例。9例多发或对称性异常的儿童中1例未检出异常,余没有显著变化。结论阿坝大骨节病,相比较单发异常而言,对称性多发异常在X线片上稳定而持久存在,这些儿童应归属于儿童大骨节病早期,应该密切关注此类儿童骨与关节发育成熟后,是否出现成人大骨节病典型临床表现和影像学特点。微量元素和维生素的补充对预防儿童大骨节病的发生,促使骨与关节异常修复有一定作用,还需大量深入研究。
Objective To understand the X-ray features of hand in children with ABA in Aba, Sichuan Province, and to observe the change of X-ray abnormality in the process of growth and development and to explore the intervention method of KBD in children. Methods A total of 110 children aged 4-14 years from 4 to 14 years old in Nadamda, Rongmuda and Gaodu Township in Rangtang County, Aba County, Sichuan Province were selected for investigation. Each year, vitamins, minerals and trace elements were given for 6 months for 2 years . Before and after the study were taken children’s hands X-ray film, and by the senior vice president of orthopedic physicians for physical examination. Results No adverse drug reactions, 3 cases were lost to follow-up. Two years later, 98 children were still in the epiphysis equivalent period. Two years later, both hands showed the middle finger flexors were reduced from 7 cases to 1 case, and found that the pyramidal hypospadias dropped from 13 cases to 7 cases, 13 cases showed that the ring refers to the proximal, mid-section single abnormal changes No abnormalities were detected in 5 cases and 2 cases were newly developed. One of nine children with multiple or symmetrical abnormalities did not detect abnormalities, but no significant changes remained. Conclusions Abkha pit disease, compared with solitary abnormalities, the symmetrical multiple anomalies are stable and persistent on X-ray films. These children should be attributed to the early stage of KBD in children. So we should pay close attention to the development of these children’s bone and joint development , Whether there is a typical adult Kashin-Beck disease clinical manifestations and imaging features. The supplementation of trace elements and vitamins to prevent the occurrence of Kashin-Beck disease in children and promote the repair of bone and joint abnormalities, but also a lot of in-depth study.