山东省菏泽地区5岁以下儿童发育性髋关节异常发病状况研究

发布时间：2018-03-20 05:09

  本文选题：发育性髋关节异常　切入点：流行病学　出处：《青岛大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的发育性髋关节脱位(developmental dislocation of the hip,DDH)在婴幼儿骨科较为常见,严重危害着儿童的健康。它是世界各地均有发生的先天畸形之一,若没有给予及时正确的治疗,髋关节将发生不可逆的一系列病理改变,最终进展为骨性关节炎,使患者的生活质量严重下降,并给社会带来沉重负担。目前国内外对于其发病详细机制还不清楚,我国有关DDH的精确的流行病学统计资料较少,各地区差异较大。鲁西南地区发病率高,患者数量多,但是对于该疾病的基本情况(如发病率、性别分布、治疗率、年龄分布等方面)缺少完善的统计资料。只是明确发病率与种族、性别、遗传,地域、环境、季节和生活习惯有关,但是对于具体关联性还尚不清楚。基于此,在导师的指导下,本人在山东省菏泽地区开展广泛调研,以期获得DDH的流行病学特点,为DDH的预防和宣传工作提供有价值的参考。方法本调研采取普查的方法,对山东省菏泽地区(包括城镇和农村)5岁及以下儿童的父母或有效监护人进行面访式问卷调查,调查表内容包括两部分,第一部分为一般资料,包括年龄、性别、居住地环境等,第二部分包括小儿出生月份、出生时体重、胎先露部位、出生方式、是否包裹及包裹时间与包裹的松紧度、是否有遗传史等有关因素。然后对调查结果进行统计分析,分析汇总后,再将结果输入计算机,使用统计学软件处理,并对结果进行分析;得出DDH的患病率、性别差异特点、患病的影响因素等。结果1.本研究共调查菏泽地区5岁以下儿童55.25万人,确诊DDH共计2196人,患病率为4‰。2.其中男童29.79万人,DDH患者406人,患病率1.4‰。女童25.46万人,DDH患者1790人,患病率7‰。男女比例为1:5。3.患儿髋关节异常的侧别中,左侧双侧右侧。4.通过卡方检验,性别女、臀先露、剖腹产、阳性家族史、襁褓包裹且时间长等因素与DDH的发病率有明显相关性,具有显著统计学意义(p0.01),寒冷季节出生、出生时有提拉下肢助啼哭、早产、母亲高龄、初胎、母亲文化程度低、居住农村等因素与DDH的发病率有相关性,有统计学意义(p0.05)。结论1.DDH总体患病率为4‰。2.男性患病率为1.4‰,女性患病率为7‰,男女比例为1:5。3.发病侧别特点:本研究左侧多高于双侧,双侧高于右侧。4.本研究显示DDH发病的风险因素中由高到低为臀位、剖腹产、家族史、襁褓包裹时间长、寒冷季节出生、出生时有提拉下肢助啼哭、早产、母亲高龄、母亲文化程度低、第一胎、居住地农村。5.菏泽地区应广泛开展对婴幼儿DDH的早期筛查,加强对有上述危险因素的高危人群的筛查和保健宣传,早期发现早期诊断早期干预疾病,有助改善患儿预后,降低致残率。
[Abstract]:Objective Developmental dislocation of the hip dislocation is common in pediatric orthopaedics and is a serious hazard to children's health. It is one of the congenital deformities that occur all over the world. There will be a series of irreversible pathological changes in the hip joint, which will eventually develop into osteoarthritis, which will seriously reduce the quality of life of the patients and bring a heavy burden to the society. At present, the detailed pathogenesis of the hip joint is not clear at home and abroad. There are few accurate epidemiological statistics about DDH in China, and there are great differences among different regions. The incidence of DDH is high and the number of patients is large in southwest of Shandong Province, but for the basic condition of the disease (such as incidence, sex distribution, treatment rate, etc.). Lack of comprehensive statistics on age distribution. It is only clear that the incidence is related to race, sex, heredity, geography, environment, seasons and habits, but the specific correlation is not clear. Under the guidance of my tutor, I carried out extensive investigation in Heze area, Shandong Province, in order to obtain the epidemiological characteristics of DDH, and to provide valuable reference for the prevention and publicity of DDH. A questionnaire survey was conducted on parents or effective guardians of children aged 5 and below in Heze, Shandong Province. The questionnaire includes two parts: the first part is general information, including age, sex, and gender. The second part includes the month of birth of the child, the weight at birth, the position of the fetus, the way of birth, whether the package and the time of the package and the tightness of the package, Whether there is genetic history and other related factors. Then statistical analysis of the survey results, analysis and summary, then input the results into the computer, use statistical software to process the results, and analyze the results; get the prevalence rate of DDH, gender difference characteristics, Results 1. A total of 552,500 children under 5 years old in Heze area were investigated in this study, and the prevalence rate was 4 鈥，

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