南方医科大学学报 ›› 2017, Vol. 37 ›› Issue (07): 924-.

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小儿发育性髋关节发育不良与先天性肌性斜颈的超声筛查

王娜,张遇乐,关步云,朱莉玲,贺雪华,方倩,梁志成   

  • 出版日期:2017-07-20 发布日期:2017-07-20

An ultrasonographic study of the correlation between developmental dysplasia of the hip and congenital muscular torticollis in children

  • Online:2017-07-20 Published:2017-07-20

摘要: 目的通过应用超声方法探讨小儿发育性髋关节发育不良(DDH)与先天性肌性斜颈(CMT)早期筛查的意义,建立小儿 DDH与CMT的同步筛查模式,提高DDH患儿的确诊率。方法对2014年1月~2017年1月于我院就诊的5060例疑似DDH与 CMT小儿进行常规超声检查,对两种疾病的诊断结果按照临床分型,不同DDH分型与不同CMT分型间是否有关联性单因素 采用χ2检验,多因素采用对应分析法进行统计分析;疑似CMT就诊来源小儿中CMT患儿与颈部正常小儿在DDH检出率上的比 较采用χ2检验。结果不同DDH分型与不同CMT分型间有关联性(χ2=331.800,P<0.001),对应分析结果表明GrafⅡa型DDH 小儿与肿块型CMT小儿有关联,GrafⅡb型、GrafⅡc型、GrafⅢ型、GrafⅣ型DDH小儿与非肿块型CMT小儿有关联;疑似CMT 就诊小儿中CMT患儿的DDH检出率显著高于颈部正常小儿(χ2=321.889,P<0.001)。结论DDH与CMT的发病有较大的关联 性,应尽早在临床上开展DDH与CMT的同步筛查,有助有提高DDH患儿的早期诊断率。

Abstract: Objective To investigate the significance of early screening of pediatric developmental dysplasia of the hip (DDH) and congenital muscular torticollis (CMT) using ultrasonography and establish a simultaneous screening model for pediatric DDH and CMT. Methods From January, 2013 to January, 2016, a total of 5060 pediatric patients with suspected DDH and CMT underwent ultrasonic examinations. The diagnostic results of the two diseases were classified into different clinical types, and Chi-square test was used to analyze the one-way relationship between different types of DDH and CMT; correspondence analysis was used for multivariate analysis of the variables. Chi-square test was used to analyze the difference between the detection rates in suspected CMT patients and the normal population. Results GrafIIa type DDH was associated with mass-type CMT in the children (χ2=331.800, P<0.001). DDH of GrafIIb, GrafIIc, Graf III, and Graf IV types were related with non-tumor type of CMT. The children with a suspected diagnosis of CMT showed a significantly higher detection rate of DDH than the normal subjects (χ2=321.889, P<0.001). Conclusion DDH is closely related with CMT. Early simultaneous screening of DDH and CMT can help to improve the early diagnosis rate of CMT in children.