摘要
目的：评价各种方法对新生儿先天性髋脱位诊断价值。材料和方法：作者采用动态－ＢＲＰ并联法、ＧｒａｆＭｏｒｉｎ并联法、Ｇｒａｆ法和Ｍｏｒｉｎ四种超声方法及Ｂａｒｌｏｗ手法和屈膝屈髋外展试验、Ａｌｉｓ征、Ｏｒｔｏｌａｎｉ征、Ｂａｒｌｏｗ征并联手法对１３２８名新生儿的２６５６个髋关节进行检查。结果：经统计学处理表明，上述各种超声方法灵敏度、约登指数明显高于手法检查，但其它三种超声方法与动态－ＢＲＰ并联超声法相比，在诊断结果上一致性差，约登指数也均偏低（均＜０．５）。结论：动态－ＢＲＰ并联超声法为目前诊断新生儿ＣＤＨ最可靠的方法，其它超声方法明显优于手法检查，而只能作为梯度筛选试验，不能作为诊断试验。由于Ｂａｒｌｏｗ手法检查的特异度、准确度、阴性预告值也均较高，无超声设备单位，也应尽量采用Ｂａｒｌｏｗ手法检查。
Objective: To evaluate the various ultrasound and clinical methods in diagnosis of congenital dislocation of the hip(CDH). Methods: The four sonographic methods (EngesaeterBRP, GrafMorin, Graf and Morin) and the clinical methods (BarlowTest, Knee flexion and hip flexion abductionTest,AllisTest, OrtolaniTest) were used for examining the hip joint in 1328 newborns. Results:The sensitiveity and Youndon index of all the ultrasound methods mentioned above were much higher than that of the clinical methods; compared with EngesaeterBRP, the results of the other three ultrasound methods had significant difference, and the Youndon index of them was lower than 0.5. Conclusion: EngesaeterBRP was the most reliable diagnostic method to detect the CDH in the newborns. The other ultrasound methods can only be used as gradient screen tests. The BarlowTest was recommended on the condition if there was no ultrasonic facilities availble for its specificity, accuracy and negative predictive value.
出处
《中华骨科杂志》
CAS
CSCD
北大核心
1997年第12期743-747,共5页
Chinese Journal of Orthopaedics
