摘要
目的分析超声定量评估婴儿发育性髋关节异常(DDH)的临床价值。方法回顾性分析2019年12月至2022年12月期间于咸阳市妇幼保健院实施髋关节筛查确诊为DDH的82例婴儿的临床资料,根据其内收稳定试验分为稳定组(n=59)和不稳定组(n=23)。统计异常关节类型(Graf分型);比较两组患儿关节超声定量检查结果(髋臼α角、β角、股骨头覆盖率、头耻距),并采用受试者工作特征曲线(ROC)分析超声定量检查结果联合诊断DDH患儿髋关节稳定性的诊断价值。比较不同月龄DDH患儿骨化中心出现率,并采用Pearson相关性模型分析骨化中心出现与月龄的相关性。结果82例DDH患儿中Ⅱa型39.02%,Ⅱb型28.05%,Ⅱc型19.51%,D型10.98%,Ⅲ型2.44%。不稳定组患儿的α角、股骨头覆盖率分别为(49.51±3.57)°、(42.58±2.64)%,明显低于稳定组的(52.20±4.47)°、(45.17±2.44)%,β角、头耻距分别为(67.20±3.38)°、(3.14±0.59)mm,明显高于稳定组的(64.60±3.47)°、(2.26±0.56)mm,差异均有统计学意义(P<0.05);经ROC分析结果显示,超声定量检查结果联合诊断DDH患儿髋关节稳定性的曲线下面积(AUC)为0.951,敏感度为95.65%,特异度为93.22%;不同月龄DDH患儿骨化中心出现率比较差异有统计学意义(P<0.05);经Pearson相关性模型分析结果显示,DDH患儿骨化中心出现与其月龄呈正相关(r=0.815,P<0.001)。结论超声定量分析可客观准确评估DDH患儿髋关节发育情况及稳定性,随着婴儿月龄增加,其股骨头骨化中心出现率越高,影响超声检查,因此临床需尽早进行检查诊断,有利于治疗及预后。
Objective To analyze the clinical value of ultrasound quantitative assessment on developmental dysplasia of the hip(DDH)in infants.Methods The clinical data of 82 infants who were diagnosed with DDH by hip screening in Xianyang Maternal and Child Health Care Hospital from December 2019 to December 2022 were retrospectively analyzed.According to the adduction stability test,the infants were divided into stable group(n=59)and unstable group(n=23).Abnormal joint types(Graf classification)were counted.The joint ultrasound quantitative examination results(acetabularαangle,βangle,femoral head coverage rate,pubofemoral distance)were compared between the two groups,and the diagnostic value of combination of ultrasound quantitative examination results in the diagnosis of hip stability in children with DDH was analyzed by receiver operating characteristic curve(ROC).The occurrence rate of ossification center was compared among DDH children with different months of age,and the correlation between occurrence of ossification center and age was analyzed by Pearson correlation model.Results Among the 82 children with DDH,39.02%were typeⅡa,28.05%were typeⅡb,19.51%were typeⅡc,10.98%were type D,and 2.44%were typeⅢ.Theαangle and femoral head coverage rate in unstable group were significantly lower than those in stable group[(49.51±3.57)ºvs(52.20±4.47)º,(42.58±2.64)%vs(45.17±2.44)%],while theβangle and pubofemoral distance were significantly higher than those in stable group[(67.20±3.38)ºvs(64.60±3.47)º,(3.14±0.59)mm vs(2.26±0.56)mm],P<0.05.ROC analysis revealed that the area under the curve(AUC),sensitivity and specificity of combination of ultrasound quantitative examination results in the diagnosis of hip stability in children with DDH were 0.951,95.65%,and 93.22%.There was a statistically significant difference in the occurrence rate of ossification center in DDH children with different months of age(P<0.05).Pearson correlation model showed that the occurrence of ossification center in children with DDH was positively correlated with the month age(r=0.815,P<0.001).Conclusion Ultrasound quantitative analysis can objectively and accurately evaluate the development and stability of hip joint in children with DDH.With the increase of month age of infants,the occurrence rate of ossification center of the femoral head increases,which affects ultrasound examination.Therefore,it is necessary to carry out clinical examination and diagnosis as soon as possible,which is conducive to treatment and prognosis.
作者
贾彩霞
崔薇
韩丽莎
JIA Cai-xia;CUI Wei;HAN Li-sha(Department of Ultrasound Medicine,Xianyang Maternal and Child Health Care Hospital,Xianyang 712000,Shaanxi,CHINA;Department of Ultrasound,Hanzhong People's Hospital,Hanzhong 723000,Shaanxi,CHINA)
出处
《海南医学》
CAS
2023年第21期3143-3146,共4页
Hainan Medical Journal
基金
陕西省教育厅科学研究基金(编号:16JK1569)。
关键词
婴儿
发育性髋关节异常
髋臼α角
β角
股骨头覆盖率
骨化中心
Infants
Developmental dysplasia of the hip
Acetabularαangle
βangle
Femoral head coverage rate
Ossification center
