| 刘方娜,李伟笠,左汴京,等.631例Graf Ⅱa型发育性髋关节发育不良不同干预后转归的回顾性分析.骨科,2023,14(3): 250-254. |
| 631例Graf Ⅱa型发育性髋关节发育不良不同干预后转归的回顾性分析 |
| Retrospective Analysis of 631 Cases of Graf Ⅱa Developmental Hip Dysplasia after Different Interventions |
| 投稿时间：2023-01-10 |
| DOI：10.3969/j.issn.1674-8573.2023.03.010 |
| 中文关键词: 髋关节脱位 先天性 超声检查 婴儿 Graf Ⅱa型 干预研究 |
| 英文关键词: Hip dislocation Congenital Ultrasonography Infant Graf type Ⅱa Intervention study |
| 基金项目:2019年度河南省医学科技攻关计划联合共建项目（LHGJ20190891） |
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| 中文摘要: |
| 目的 对比分析Pavlik干预和非Pavlik干预（蛙抱、髋关节外展操、宽尿不湿等家庭干预）治疗Graf Ⅱa型发育性髋关节发育不良（DDH）患儿的疗效。方法 回顾性分析河南省儿童医院2016年2月至2022年7月收治的Graf Ⅱa型DDH患儿的临床资料，共纳入631例（833髋），所有患儿均进行超声随访。分别在0~6周Graf Ⅱa型患儿（300髋），6~12周Graf Ⅱa（+）型患儿（478髋），6~12周Graf Ⅱa（-）型患儿（55髋）中观察Pavlik干预（Pavlik组）和非Pavlik干预（非Pavlik组）的效果，比较两组患儿的初始α角、转归正常的时间及α角、α角增加值。结果 Pavlik干预组和非Pavlik干预组均无并发症出现。0~6周Graf Ⅱa型患儿中，Pavlik组的初始α角明显低于非Pavlik组（53.83°±2.56° vs. 57.23°±1.65°），α角增加值显著高于非Pavlik组（10.43°±1.21° vs. 6.36°±1.45°），转归正常的时间明显少于非Pavlik组［（40.09±19.40） d vs.（45.76±17.57） d］；6~12周Graf Ⅱa（+）型患儿中，Pavlik组的初始α角明显低于非Pavlik组（56.53°±1.63° vs. 57.75°±1.15°），α角增加值显著高于非Pavlik组（7.52°±1.26° vs. 5.84°±1.71°），转归正常的时间明显少于非Pavlik组［（34.31±12.82） d vs. （43.71±19.98） d］；6~12周Graf Ⅱa（-）型患儿中，Pavlik组的转归正常时间明显少于非Pavlik组［（45.80±16.14） d vs. （57.33±14.40） d］。组间比较，差异均有统计学意义（P＜0.05）。结论 Pavlik干预、非Pavlik干预均可治愈Graf Ⅱa型DDH，相比之下，Pavlik挽具更能缩短转归正常的时间。 |
| 英文摘要: |
| Objective To compare and analyze the efficacy of Pavlik intervention and non-Pavlik intervention (abduction embrace, hip abduction exercise, wide diaper flexion and other family interventions) in the treatment of children with Graf type Ⅱa developmental hip dysplasia (DDH). Methods A retrospective analysis was conducted on the data of Graf type Ⅱa DDH patients admitted to Henan Children's Hospital from February 2016 to July 2022. A total of 631 cases (833 hips) were included, and all patients were followed up by ultrasound. The effectiveness of Pavlik intervention (Pavlik group) and non-Pavlik intervention (non-Pavlik group) was observed in Graf type Ⅱa children (300 hips) at 0-6 weeks, Graf type Ⅱa (+) children (478 hips) at 6-12 weeks, and Graf type Ⅱa (-) children (55 hips) at 6-12 weeks. The outcomes consisted of the time to recovery, initial α angle and change in α angle after intervention. Results The results showed that neither the Pavlik intervention group nor the non-Pavlik intervention group had any complications. In the Graf type Ⅱa DDH group at 0-6 weeks, the initial α angle in the Pavlik group was significantly lower than that in the non-Pavlik group (53.83°±2.56° vs. 57.23°±1.65°), the change in α angle in the Pavlik group was significantly higher than that in the non-Pavlik group (10.43°±1.21° vs. 6.36°±1.45°), and the time to recovery in the Pavlik group was significantly shorter than that in the non-Pavlik group ［(40.09±19.40) d vs. (45.76±17.57) d］. In the Graf type Ⅱa(+) DDH group of 6-12 weeks, the initial α angle in the Pavlik group was significantly lower than that in the non-Pavlik group (56.53°±1.63° vs. 57.75°±1.15°), the change in α angle in the Pavlik group was significantly higher than that in the non-Pavlik group (7.52°±1.26° vs. 5.84°±1.71°), and the time to recovery in the Pavlik group was significantly shorter than that in the non-Pavlik group ［(34.31±12.82) d vs. (43.71±19.98) d］. In the Graf type Ⅱa(-) DDH group of 6-12 weeks, the time to recovery in the Pavlik group was significantly shorter than that in the non-Pavlik group ［(45.80±16.14) d vs. (57.33±14.40) d］. Conclusion The Pavlik intervention and non-Pavlik intervention can both be used to treat Graf type Ⅱa DDH. Comparatively, Pavlik harness can shorten the durationof recovery, thus allowing for a faster recovery. |
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