文章摘要
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)
作者单位E-mail
刘方娜 郑州大学附属儿童医院(河南省儿童医院、郑州儿童医院)骨科郑州 450018 yezi.2502@163.com 
李伟笠 郑州大学附属儿童医院(河南省儿童医院、郑州儿童医院)骨科郑州 450018  
左汴京 郑州大学附属儿童医院(河南省儿童医院、郑州儿童医院)骨科郑州 450018  
Weyland Cheng 郑州大学附属儿童医院(河南省儿童医院、郑州儿童医院)骨科郑州 450018  
孙克明 郑州大学附属儿童医院(河南省儿童医院、郑州儿童医院)骨科郑州 450018  
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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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