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

【摘要】：目的發(fā)育性髖關(guān)節(jié)脫位(developmental dislocation of the hip,DDH)在嬰幼兒骨科較為常見,嚴(yán)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(shí)正確的治療,髖關(guān)節(jié)將發(fā)生不可逆的一系列病理改變,最終進(jìn)展為骨性關(guān)節(jié)炎,使患者的生活質(zhì)量嚴(yán)重下降,并給社會(huì)帶來沉重負(fù)擔(dān)。目前國內(nèi)外對(duì)于其發(fā)病詳細(xì)機(jī)制還不清楚,我國有關(guān)DDH的精確的流行病學(xué)統(tǒng)計(jì)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(duì)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(jì)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(xí)慣有關(guān),但是對(duì)于具體關(guān)聯(lián)性還尚不清楚�；诖�,在導(dǎo)師的指導(dǎo)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(xué)特點(diǎn),為DDH的預(yù)防和宣傳工作提供有價(jià)值的參考。方法本調(diào)研采取普查的方法,對(duì)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(hù)人進(jìn)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(shí)體重、胎先露部位、出生方式、是否包裹及包裹時(shí)間與包裹的松緊度、是否有遺傳史等有關(guān)因素。然后對(duì)調(diào)查結(jié)果進(jìn)行統(tǒng)計(jì)分析,分析匯總后,再將結(jié)果輸入計(jì)算機(jī),使用統(tǒng)計(jì)學(xué)軟件處理,并對(duì)結(jié)果進(jìn)行分析;得出DDH的患病率、性別差異特點(diǎn)、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(jì)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(guān)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(yàn),性別女、臀先露、剖腹產(chǎn)、陽性家族史、襁褓包裹且時(shí)間長(zhǎng)等因素與DDH的發(fā)病率有明顯相關(guān)性,具有顯著統(tǒng)計(jì)學(xué)意義(p0.01),寒冷季節(jié)出生、出生時(shí)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(guān)性,有統(tǒng)計(jì)學(xué)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(diǎn):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(fēng)險(xiǎn)因素中由高到低為臀位、剖腹產(chǎn)、家族史、襁褓包裹時(shí)間長(zhǎng)、寒冷季節(jié)出生、出生時(shí)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(yīng)廣泛開展對(duì)嬰幼兒DDH的早期篩查,加強(qiáng)對(duì)有上述危險(xiǎn)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(yù)疾病,有助改善患兒預(yù)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(hào)：1637639