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GrafⅡa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GrafⅡa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GrafⅡa型患儿(300髋),6~12周GrafⅡa(+)型患儿(478髋),6~12周GrafⅡa(-)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GrafⅡa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GrafⅡa(+)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GrafⅡa(-)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GrafⅡa型DDH,相比之下,Pavlik挽具更能缩短转归正常的时间。
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 typeⅡa developmental hip dysplasia(DDH).Methods A retrospective analysis was conducted on the data of Graf typeⅡa 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 typeⅡa children(300 hips)at 0⁃6 weeks,Graf typeⅡa(+)children(478 hips)at 6⁃12 weeks,and Graf typeⅡa(-)children(55 hips)at 6⁃12 weeks.The outcomes consisted of the time to recovery,initialαangle and change inαangle after intervention.Results The results showed that neither the Pavlik intervention group nor the non⁃Pavlik intervention group had any complications.In the Graf typeⅡa DDH group at 0⁃6 weeks,the initialαangle 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 inαangle 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 typeⅡa(+)DDH group of 6⁃12 weeks,the initialαangle 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 inαangle 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 typeⅡa(-)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 typeⅡa DDH.Comparatively,Pavlik harness can shorten the durationof recovery,thus allowing for a faster recovery.
作者
刘方娜
李伟笠
左汴京
Weyland Cheng
孙克明
LIU Fang-na;LI Wei-li;ZUO Bian-jing;Weyland Cheng;SUN Ke-ming(Department of Orthopedics,Children’s Hospital Affiliated to Zhengzhou University,Henan Children’s Hospital,Zhengzhou Children’s Hospital,Zhengzhou 450018,China)
出处
《骨科》
CAS
2023年第3期250-254,共5页
ORTHOPAEDICS
基金
2019年度河南省医学科技攻关计划联合共建项目(LHGJ20190891)。
