发育性髋关节发育不良及关节松弛相关性探究.docVIP

发育性髋关节发育不良及关节松弛相关性探究 　 作者：史立伟，赵群，张立军，吉士俊，李连永 【摘要】 [目的]探讨发育性髋关节发育不良和关节松弛之间是否相关。[方法]对2006年1～12月之间于中国医科大学盛京医院就治的176名发育性髋关节发育不良患者和192例正常人进行对照研究。患者年龄6个月～15岁之间，平均年龄3.54岁，其中男23例，女153例;正常对照组年龄为4个月～15岁之间，平均年龄为3.67岁，其中男33例，女159例。发育性髋关节发育不良的诊断依据为：小儿骨科专业医师的查体，骨盆正位像放射线所见和髋关节超声影像学所见。关节松弛的诊断依据为Wynne Davies提出的关节松弛评定标准。所收集数据进行χ2检验，以及Spearman检验。采用SPSS 10.0软件进行统计学分析，Plt;0.05视为统计学上显著差异。[结果]176名DDH患者中，3分以上患者有107名，总比率为60.80%，192例正常对照组中关节松弛总比率为28.15%，二者之间的差异经组间比较、χ2检验Plt;0.005，差异显著。各不同年龄组的关节松弛发病率经Spearman检验Pgt;0.50，可见年龄与关节松弛发病率无相关性。56人最初采用内收肌切断、手法复位、石膏固定术治疗，其中16人术后复查出现脱位，手法复位成功率为71.43%，较其他报道明显为低。30髋采用髋臼成形、股骨近端旋转截骨术治疗，3髋(10%)术后出现髋关节僵硬，较本科既往统计的手术后髋关节僵比率20.4%(87/429)明显为低。还有3髋(10%)在术后2年随访中仍有髋臼发育不良需要再次手术治疗，与其他报道差异不明显。[结论]关节松弛与髋关节发育不良有明显相关性，关节松弛对DDH患者手法复位和切开复位均有影响，不论是在DDH术前患者的情况评估方面，还是在DDH术后患者预后的判断方面，关节松弛现象都不能忽视。 【关键词】 发育性髋关节发育不良; 病因学; 关节松弛 　　Abstract: [Objective]To study the relationship between arthrochalasis and developmental dislocation of hip(DDH). [Methods]One hundred and seventy-six patients with DDH treated from Jaunary 2006 to December 2006 in the Shengjing Hospital of China Medical University were evaluated retrospectively. The average age was 3.54 years old (range, from 6 months to 15 years),with 153 females and 23 males. Eighty-four patients had both, 58 left and 34 right.Totally 192 normal children were controls, and the average age was 3.67 years old (range, from 4 months to 15 years). The diagnosis of DDH was depended on clinical manifestations,radiography and ultrasonography.The criteria of arthrochalasia were the standards proposed by Wynne Davies. SPSS version 10.0 for Windows was used to perform statistical analysis.χ2 test and spearman test was conducted for obtained data. A Plt;0.05 was considered significant.[Results]Totally 107 of 176 had more than 3 scores(60.80%),54 normal controls(28.18%)had arthrochalasis, with a Plt;0.005 being considered significant. Fifty-six patients were treated with close reduction, but 16 failed to respond, with the success rate of 71.43%, whi