目的 了解北京市朝阳区0～6月龄儿童发育性髋关节发育不良(developmental dysplasia of the hip，DDH)区内转诊复筛情况，进一步探寻儿童DDH在各级儿童保健门诊的筛查模式。方法 采用髋关节临床查体和髋关节超声检查相结合的方法，对朝阳区2021-2023年期间社区转诊的具有DDH阳性体征的3 511名0～6月龄儿童进行复筛，并对复筛结果进行统计学分析。结果 在3 511名儿童中，DDH复筛阳性147例，检出率为4。2％。其中女童105例，检出率为5。20％，高于男童检出率，男女童比较差异有统计学意义(P＜0。05)。对不同月龄儿童阳性率进行比较，1月龄儿童阳性检出率8。6％，高于其他月龄检出率，不同月龄比较差异有统计学意义(P＜0。05)。DDH发生在左侧的有67人，占比为45。58％，左侧发生率最高。按Graf标准分型，Ⅱa型145人，占比97。28％，发生率最高。logistic回归分析显示，性别是儿童发生DDH的危险因素(P＜0。05)。结论 0～6月龄儿童DDH的三级网络筛查机制证实符合朝阳区实际情况。临床查体和B超检查相结合的筛查方式能更有效的将DDH儿童筛查出来，在DDH的早期发现、早期诊断中发挥着重要的作用。
Discussion on the screening model of hip developmental dysplasia in children aged 0 to 6 months
Objective To investigate the referrals of developmental dysplasia of the hip(DDH)in children aged 0 to 6 months in Chaoyang district of Beijing,and to further explore the screening model of developmental dysplasia of the hip(DDH)in children's health care clinics at all levels.Methods By means of clinical examination of hip joint and ultrasound examination of hip joint,a total of 3 511 children aged 0 to 6 months with positive signs of developmental dysplasia of the hip(DDH)were rescreened,who were referred by the community in Chaoyang District from 2021 to 2023.Results Among 3 511 children,147 cases were positive for DDH,the detection rate was 4.2％.105 were girls among them,the detection rate was 5.20％,which was higher than that of boys,and the difference between boys and girls was statistically significant(P＜0.05).Compared the positive rate of children of different months,the positive detection rate of children of 1 month was 8.6％,which was higher than that of other months,and the difference was statistically significant(P＜0.05).There are 67 people with DDH on the left side,who accounted for 45.58％,and the left side has the highest incidence.According to Graf standard classification,there were 145 people with type of Ⅱa,who accounted for 97.28％,and there were the highest incidence of Ⅱa.Logistic regression analysis showed that gender was risk factors for DDH in children(P＜0.05).Conclusion The three-lev-el network screening mechanism of DDH in children aged 0～6 months was consistent with the actual situation in Chaoyang District,which is proved.The combination of clinical physical examination and B-ultrasonography can screen DDH children more effectively,which plays an important role in the early detection and diagnosis of DDH.
ChildrenDevelopmental dysplasia of the hipScreening
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