Pavlik吊带治疗婴幼儿发育性髋关节发育不良的疗效观察

doi:10.3760/cma.j.cn101202-20210605-00149

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摘要目的探讨Pavlik吊带治疗6个月内发育性髋关节发育不良（DDH）的疗效。方法回顾性研究。纳入2015年7月—2019年7月厦门市妇幼保健院小儿外科DDH患儿66例68髋,其中男4例4髋,女62例64髋;年龄30~180（90.4±38.2）d。患儿治疗前均行髋关节超声检查确诊,依据超声检查Graf分型标准分型：髋关节未脱位48髋（未脱位组）,其中Ⅱa（-）型2髋、Ⅱb型24髋、Ⅱc型22髋;脱位20髋（脱位组）,其中D型7髋、Ⅲ型5髋、Ⅳ型8髋。患儿均采取Pavlik吊带治疗。观察患儿佩戴吊带时间、治疗成功率,以及治疗期间并发症发生情况;对比治疗成功和失败患儿起始治疗年龄的差异;将患儿分为≤60 d、61~90 d、91~120 d、>120~180 d 4个年龄段,对比不同年龄段患儿治疗成功率;对比未脱位和脱位2组患儿治疗成功率,观察治疗有效患儿结束治疗后股骨头缺血性坏死及髋臼发育残余畸形等发生情况。结果 66例68髋吊带佩戴时间2~22（10.2±4.0）周,治疗成功50例51髋、失败16例17髋,成功率75.0%（51/68）。吊带治疗成功患儿开始治疗年龄为（83.0±34.5）d,明显小于治疗失败患儿的（115.1±38.2）d,差异有统计学意义（t=3.18,P=0.002）。不同年龄段患儿治疗情况比较,年龄≤60 d 患儿治疗成功率最高（20/21,髋）,年龄>120~180 d患儿治疗成功率最低（3/12,髋）,差异有统计学意义（χ²=22.38,P<0.001）。未脱位48髋治疗成功40髋（83.3%）,脱位20髋治疗成功11髋（55.0%）,差异有统计学意义（χ²=6.04,P=0.014）。吊带治疗成功48例49髋获得随访,随访时间1~42个月,平均14个月。随访期间患儿关节外观及活动度正常,可行走者步态正常,无股骨头缺血性坏死及髋臼发育残余畸形发生。结论 Pavlik吊带治疗6个月内DDH患儿治疗成功率高,治疗年龄早、髋关节未脱位者治疗效果好,可作为6个月内DDH患儿的首选方法,但还应根据患儿的具体情况制定个体化的治疗方案。

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	陈善本
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关键词 ：髋脱位,先天性, 发育性髋关节发育不良, Pavlik吊带, 儿童

Key words： Hip dislocation,congenital Developmental dysplasia of the hip Pavlik harness Child

收稿日期: 2021-06-05

通讯作者: 冯林,Email：lfeng324@yahoo.com

引用本文:

陈善本, 冯林, 唐宜莘. Pavlik吊带治疗婴幼儿发育性髋关节发育不良的疗效观察[J]. 中华解剖与临床杂志, 2022, 27(4): 281-284.
Chen Shanben, Feng Lin, Tang Yishen. Efficacy observation of Pavlik harness in the treatment of developmental dysplasia of the hip in infant. Chinese Journal of Anatomy and Clinics, 2022, 27(4): 281-284.

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http://www.cjac.com.cn/CN/10.3760/cma.j.cn101202-20210605-00149 或 http://www.cjac.com.cn/CN/Y2022/V27/I4/281

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