摘要
目的:Graf法、Harcke法联合筛查发育性髋关节发育不良(DDH)的临床应用价值,探讨髋臼窝发育和关节稳定性的关系。方法:选择6004例(12008髋)为研究对象,均接受Graf法、Harcke法检查。应用Harcke技术评价髋关节外展程度和稳定性,应用Graf技术对髋关节分型,并与临床诊断比较,计算Graf法、Harcke法及两者联合诊断DDH的敏感度、特异度、阳性率及漏诊率。结果:6004例(12008髋)中,145例(165髋)存在DDH。Graf法阳性156髋,Harcke法阳性29髋(其中Graf法阴性9髋),两者联合诊断165髋。Graf法、Harcke法联合应用诊断DDH的敏感度(100.0%)高于单独应用Graf法(94.5%)、Harcke法(17.6%)。Graf法、Harcke法联合应用未漏诊,优于单独应用Graf法和Harcke法。Graf法、Harcke法联合应用与单纯应用Graf法差异无统计学意义(P>0.05);Graf法、Harcke法联合应用与单独应用Harcke法差异有统计学意义(均P<0.05)。结论:Graf法联合Harcke法筛查DDH能满足临床筛查的需求,Harcke法辅助Graf法从髋臼窝的发育和关节稳定性2个角度诊断,可提高检出率,减少漏诊率,并能指导临床治疗、监测随访,敏感度高。
Objective:To evaluate the clinical value of Graf method combined with Harcke method in screening developmental dysplasia of the hip(DDH)and to explore the relationship between acetabular fossa development and joint stability.Methods:A total of 6004 cases(12008 hips)were selected as the research objects,and they were all examined by Graf method and Harcke method.The degree of abduction and stability of hip joint were evaluated by using the Harcke technique,and the hip joint was classified by Graf technique.Compared with clinical diagnosis,the sensitivity,specificity,positive rate and missed diagnosis rate of Graf method,Harcke method and their combined examination were calculated.Results:Among 6004 cases(12008 hips),145 cases(165 hips)had DDH.156 hips were diagnosed by Graf method,29 hips by Harcke method,and a total of 165 hips were diagnosed by the combination method.The sensitivity of the combined application of Graf and Harcke method in the diagnosis of DDH(100.0%)was higher than that of Graf method(94.5%)and Harcke method(17.6%).The missed diagnosis rate of the combination of Graf and Harcke method(0)was lower than that of Graf method and Harcke method alone.There was no significant difference between the combined application of Graf and Harcke method and the simple application of Graf method(P>0.05).But there was a significant difference between the combined application of Graf and Harcke method and the simple application of Harcke method(P<0.05).Conclusions:Graf method combined with Harcke method in screening DDH can meet the needs of clinical screening of DDH,and Harcke method assisted Graf method to diagnose from the two perspectives of acetabular fossa development and joint stability can improve the detection rate,reduce the missed diagnosis rate,guide clinical treatment and convenient to monitor and follow-up with high sensitivity.
作者
左汴京
王丹
霍亚玲
ZUO Bianjing;WANG Dan;HUO Yaling(Department of Ultrasound Medicine,Children’s Hospital Affiliated of Zhengzhou University,Henan Children’s Hospital,Zhengzhou Children’s Hospital,Zhengzhou 450000,China)
出处
《中国中西医结合影像学杂志》
2022年第1期81-84,共4页
Chinese Imaging Journal of Integrated Traditional and Western Medicine
基金
河南省医学科技攻关计划联合共建项目(LHGJ20190951)。
关键词
髋脱位
先天性
超声检查
Hip dislocation,congenital
Ultrasonography
