本文選題：發(fā)育性髖關節(jié)異常　切入點：流行病學　出處：《青島大學》2017年碩士論文　論文類型：學位論文

【摘要】：目的發(fā)育性髖關節(jié)脫位(developmental dislocation of the hip,DDH)在嬰幼兒骨科較為常見,嚴重危害著兒童的健康。它是世界各地均有發(fā)生的先天畸形之一,若沒有給予及時正確的治療,髖關節(jié)將發(fā)生不可逆的一系列病理改變,最終進展為骨性關節(jié)炎,使患者的生活質(zhì)量嚴重下降,并給社會帶來沉重負擔。目前國內(nèi)外對于其發(fā)病詳細機制還不清楚,我國有關DDH的精確的流行病學統(tǒng)計資料較少,各地區(qū)差異較大。魯西南地區(qū)發(fā)病率高,患者數(shù)量多,但是對于該疾病的基本情況(如發(fā)病率、性別分布、治療率、年齡分布等方面)缺少完善的統(tǒng)計資料。只是明確發(fā)病率與種族、性別、遺傳,地域、環(huán)境、季節(jié)和生活習慣有關,但是對于具體關聯(lián)性還尚不清楚�；诖�,在導師的指導下,本人在山東省菏澤地區(qū)開展廣泛調(diào)研,以期獲得DDH的流行病學特點,為DDH的預防和宣傳工作提供有價值的參考。方法本調(diào)研采取普查的方法,對山東省菏澤地區(qū)(包括城鎮(zhèn)和農(nóng)村)5歲及以下兒童的父母或有效監(jiān)護人進行面訪式問卷調(diào)查,調(diào)查表內(nèi)容包括兩部分,第一部分為一般資料,包括年齡、性別、居住地環(huán)境等,第二部分包括小兒出生月份、出生時體重、胎先露部位、出生方式、是否包裹及包裹時間與包裹的松緊度、是否有遺傳史等有關因素。然后對調(diào)查結(jié)果進行統(tǒng)計分析,分析匯總后,再將結(jié)果輸入計算機,使用統(tǒng)計學軟件處理,并對結(jié)果進行分析;得出DDH的患病率、性別差異特點、患病的影響因素等。結(jié)果1.本研究共調(diào)查菏澤地區(qū)5歲以下兒童55.25萬人,確診DDH共計2196人,患病率為4‰。2.其中男童29.79萬人,DDH患者406人,患病率1.4‰。女童25.46萬人,DDH患者1790人,患病率7‰。男女比例為1:5。3.患兒髖關節(jié)異常的側(cè)別中,左側(cè)雙側(cè)右側(cè)。4.通過卡方檢驗,性別女、臀先露、剖腹產(chǎn)、陽性家族史、襁褓包裹且時間長等因素與DDH的發(fā)病率有明顯相關性,具有顯著統(tǒng)計學意義(p0.01),寒冷季節(jié)出生、出生時有提拉下肢助啼哭、早產(chǎn)、母親高齡、初胎、母親文化程度低、居住農(nóng)村等因素與DDH的發(fā)病率有相關性,有統(tǒng)計學意義(p0.05)。結(jié)論1.DDH總體患病率為4‰。2.男性患病率為1.4‰,女性患病率為7‰,男女比例為1:5。3.發(fā)病側(cè)別特點:本研究左側(cè)多高于雙側(cè),雙側(cè)高于右側(cè)。4.本研究顯示DDH發(fā)病的風險因素中由高到低為臀位、剖腹產(chǎn)、家族史、襁褓包裹時間長、寒冷季節(jié)出生、出生時有提拉下肢助啼哭、早產(chǎn)、母親高齡、母親文化程度低、第一胎、居住地農(nóng)村。5.菏澤地區(qū)應廣泛開展對嬰幼兒DDH的早期篩查,加強對有上述危險因素的高危人群的篩查和保健宣傳,早期發(fā)現(xiàn)早期診斷早期干預疾病,有助改善患兒預后,降低致殘率。
[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，

本文編號：1637639