Li Yanhua,Lv Xuemin,Zhang Yuchen,et al.Preventive significance of early screening for developmental dysplasia of the hip and its influencing factors[J].Journal of Clinical Pediatric Surgery,2019,18(05):395-399.[doi:10.3969/j.issn.1671-6353.2019.05.011]
早期筛查对发育性髋关节发育不良的预防意义及其影响因素分析
- Title:
- Preventive significance of early screening for developmental dysplasia of the hip and its influencing factors
- 关键词:
- 发育性髋关节脱位/诊断; 新生儿筛查/方法; 疾病影响状态调查
- 分类号:
- R726.8;R181.3+2
- 摘要:
- 目的 分析早期筛查对发育性髋关节发育不良的预防意义及其影响因素。方法 以北京积水潭医院2009年1月至2013年12月间收治住院的1 376名发育性髋关节脱位（developmental dysplasia of the hip，DDH） DDH患儿为研究对象，对患儿父母进行不记名问卷调查。根据初次就诊年龄、不同就诊途径对所有受试者进行分组，问卷调查内容包括患儿初次就诊年龄、患儿父母文化程度、家庭中是否有从医人员、患儿年平均医疗费用、患儿骨科疾病患病史、首次就诊的主管医生级别等。结果 2009年1月至2013年12月间，2岁以下DDH患儿占当年全部初次就诊患儿总数的比例呈现逐年升高的趋势（P<0.05），而6岁以上DDH患儿占当年全部初次就诊患儿总数的比例呈现逐年降低的趋势（P<0.05）。由当地医生发现并推荐就诊的患儿比例呈不断上升的趋势。Logistic回归分析结果显示，入选的变量包括患儿父亲文化程度、患儿母亲文化程度以及首次就诊的主管医生级别。结论 新生儿进行髋关节早期筛查的意识已经得到一定程度的提高，疾病诊疗相关知识逐渐丰富，患儿父母亲文化程度及首次就诊的主管医生级别是DDH患儿接受早期筛查年龄的主要影响因素。
- Abstract:
- Objective To explore the preventive significance and influencing factors of developmental dysplasia of the hip (DDH) for early screening.Methods A total of 1376 DDH children hospitalized from January 2009 to December 2013 were recruited and divided according to the age of initial visit and different treatment routes.Their parents were surveyed by an anonymous questionnaire of age of initial visit,family’s wealth status,parental education level,medical insurance,average annual medical expenses,history of orthopedic disease and level of attending physician during an initial visit.Results The proportion of DDH children aged under 2 years showed a year-on-year increase among the total number of children visiting initially (P<0.05) while the proportion of DDH children aged over 6 years accounted for a decreasing proportion (P<0.05).The proportion of children diagnosed and referred by local physicians was on the rise.Logistic regression analysis showed that the relevant variables included paternal/maternal educational level and seniority of physician during an initial visit.Conclusion There is a heightened awareness of early screening for hip dislocation in newborns.And the knowledge of disease diagnosis and treatment is gradually expanding.Parental education level and seniority of physician during an initial visit are two major influencing factors of early screening age of DDH children.
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备注/Memo
收稿日期:2018-06-15。
基金项目:北京市卫生系统高层次卫生技术人才培养项目资助（编号：2015-3-032）；北京市医院管理局儿科学协同发展中心专项经费资助（编号：XTYB201821）
通讯作者:吕学敏,Email:Lxm98@sina.com