【摘要】：目的:探討跟骨骨骺從出現(xiàn)到閉合階段發(fā)育的X線形態(tài)特征和規(guī)律。材料與方法:從2012年5月~2016年2月期間,連續(xù)搜集整理1177例在日照市人民醫(yī)院就診的19歲以下兒童青少年踝、足跗關(guān)節(jié)X線側(cè)位片,其中男性兒童青少673例,女性兒童青少504例,這些入選兒童青少年的年齡范圍為4月~18歲。本次實(shí)驗(yàn)統(tǒng)計分析中每一歲劃分為一個年齡組,每一組男女性兒童青少年20~50例各不等。觀察分析每一年齡組兒童青少年跟骨骨骺出現(xiàn)及完全閉合例數(shù)、跟骨骨骺的密度(分致密型、松質(zhì)骨型兩型)、跟骨骨骺最先閉合部位(跟骨下部、跟骨上部)、跟骨骨骺透亮線以及兒童暫時性發(fā)育性跟骨骨刺出現(xiàn)與否隨年齡變化的規(guī)律和特點(diǎn)及男女性別差異。結(jié)果:在所觀察的兒童青少年群體中,女性兒童青少年跟骨骨骺最早于3歲年齡組出現(xiàn)1例,9歲及以后的年齡組跟骨骨骺全部都出現(xiàn),女性兒童青少年跟骨骨骺完全閉合年齡最早于11歲年齡組出現(xiàn)1例,16歲及以后的年齡組跟骨骨骺全部都閉合;男性兒童青少年跟骨骨骺最早于5歲年齡組出現(xiàn)1例,11歲及以后年齡組跟骨骨骺全部都出現(xiàn),男性兒童青少年跟骨骨骺完全閉合年齡最早于12歲年齡組出現(xiàn)1例,18歲年齡組全部都閉合。在所有的入選研究對象中共有54例兒童在跟骨骨骺出現(xiàn)前有暫時性發(fā)育性跟骨骨刺(假性骨刺)出現(xiàn),其中女性兒童19例,男性兒童35例。跟骨骨骺密度(致密型、松質(zhì)骨型)、最先閉合部位(下部、上部)、透亮線和暫時性發(fā)育性跟骨骨刺出現(xiàn)與否性別差異χ2檢驗(yàn)均無顯著統(tǒng)計學(xué)意義(χ2=1.22、0.03、0.52、2.45,均P0.05)。在所有的研究對象中跟骨骨骺最先閉合部位,下部6.55%(男12例,女17例),上部2.93%(男5例,女8例)。結(jié)論:認(rèn)識跟骨骨骺發(fā)育的X線規(guī)律,有助于跟骨骨骺疾病的X線診斷和鑒別。
[Abstract]:Objective: to investigate the X-ray features and regularity of epiphysis development from appearance to closure. Materials and methods: from May 2012 to February 2016, 1177 cases of children under 19 years old under the age of 19 and lateral radiography of tarsal joint of foot were collected and sorted in Rizhao people's Hospital. There were 504 female children who were enrolled in the age range from April to 18. Each year of age was divided into an age group, and 2050 cases of male and female children and adolescents were divided into two groups. The occurrence and complete closure of calcaneal epiphysis, the density of calcaneal epiphysis (divided into compact type and cancellous bone type) and the first closed site of calcaneal epiphysis (proximal calcaneus and upper calcaneus) were observed and analyzed. The regularity and characteristics of calcaneal epiphysis clear line and temporary developmental calcaneal bone spines in children with age and gender difference. Results: the epiphysis of calcaneal bone in female children and adolescents was first found in the age group of 3 years old, and all the epiphysis of calcaneus appeared in the age group of 9 years old and after, among the observed groups of children and adolescents, the epiphysis of calcaneus appeared in the female children and adolescents. The complete closure of calcaneal epiphysis occurred in female children and adolescents at the earliest age of 11 years, and all of the calcaneal epiphyses were closed in the 16 and after age groups. The epiphysis of calcaneal bone in male children and adolescents first appeared in the age group of 5 years old, all the epiphysis of calcaneus appeared in the age group of 11 years and after, and the complete closure of the epiphysis of calcaneus appeared in 1 case in the age group of 12 years of age. All of the 18-year-old group were closed. A total of 54 children (19 female and 35 male) had transient developmental calcaneal spines (pseudo-bone spines) before epiphysis of calcaneus. The density of calcaneal epiphysis (compact type, cancellous bone type), the first closed site (lower part, upper part), clear line and temporary developmental calcaneal bone spines had no significant difference in sex (蠂 ~ 2 ~ 2 test) (蠂 ~ 21.222.45). P 0.05). Among all the subjects, 6.55% (12 males, 17 females) and 2.93% (5 males, 8 females) in the proximal part of the calcaneal epiphysis were closed first. Conclusion: understanding the X-ray rule of calcaneal epiphysis is helpful to the diagnosis and differential diagnosis of calcaneal epiphyseal disease.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R726.8;R816.8

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