Abstract:

Objective　To analyze the relevant influencing factors of curative effect in children with developmental dysplasia of the hip (DDH) aged 6-18 months through literature samples. Methods　Based on the content analysis method, CNKI, VIP, WF, CBM, and PubMed journals were used as the data retrieval platforms to analyze the data resources. The keyword of the search was "infant developmental dysplasia of the hip", and the search interval was from the establishment of the databases to October 1, 2022. A total of 40 children with DDH who were treated with closed reduction combined with modified plaster external fixation of hip body position were retrospectively selected from Pediatric Orthopaedics, Nanchang Hongdu Hospital of Traditional Chinese Medicine from January 2020 to January 2022 , including 19 boys and 21 girls, 21 cases aged <12 months and 19 cases aged ≥12 months. According to the effect indexes, they were divided into an effect response group (22 cases) and a non-effect response group (18 cases), and the differences of influencing factors between the two groups were compared and analyzed by two-way analysis. Rank sum test and χ² test were used. Results　After analyzing 84 target samples, it was found that the primary influencing factors of DDH in infants and young children were demographic sociological factors, disease assessment factors, biological information factors, and other influencing factors, including 19 secondary factors. In the effect response group, the rates of aged <12 months, gender (female), Tönnis degree (Ⅰ degree), Grafb classification (D), acetabular index ≥35°, cephalic position of cartilaginous acetabulum, intra-acetabular tissue (right-left diameter <0.9 cm, anteroposterior diameter <1.5 cm, and area <1.4 cm²), medial cisterna space of hip joint <6 mm, glenolabial position head, no hypertrophy of glenoid labrum, femoral head h/b ratio >0.1 (concentric reduction), femoral head anterior cervical inclination <13°, femoral head perfusion change type (type A), no extension or hypertrophy of round ligament, ossified nucleus development, vascular classification (type Ⅲ), traction time before reduction ≥14 d, and fixed time after reduction ≤6 months were higher than those in the non-effect response group (all P<0.05). Conclusion　The clinic should pay attention to the relevant influencing factors of DDH children aged 6-18 months, and further explore the unknown influencing factors and the influencing depth and width of the combination of various factors, so as to optimize the targeted treatment scheme that can effectively treat DDH children aged 6-18 months.

Key words:

Content analysis method, Developmental dysplasia of the hip, Factors related to efficacy, Plaster external fixation of hip body position, Indications

摘要：

目的　通过文献样本分析6～18月龄发育性髋关节发育不良（DDH）患儿疗效的相关影响因素。方法　基于内容分析法，以中国知网（CNKI）、维普中文科技期刊全文数据库（VIP）、万方数据知识服务平台（WF）、中国生物医学数据库（CBM）和PubMed数据库为数据检索平台，检索主题词为“婴幼儿发育性髋关节发育不良”，检索区间为从建库至2022年10月1日，进行数据资源分析。回顾性选取2020年1月至2022年1月于南昌市洪都中医院小儿骨科收治的采用闭合复位联合改良后髋人体位石膏外固定法治疗的DDH患儿40例，其中男19例，女21例，<12个月21例，≥12个月19例；按照效应指标分为效应应答组（22例）和效应无应答组（18例），通过双向分析思路比较分析两组影响因素的差异。采用秩和检验、χ²检验。结果　分析84条目标样本，发现婴幼儿DDH的一级影响因素为人口社会学因素、病情评估因素、生物学信息因素与其他影响因素4大类，二级因素共19种。效应应答组中月龄<12个月、性别（女）、Tönnis分度（Ⅰ度）、Grafb分型（D型）、髋臼指数≥35°、软骨性髋臼位置头侧、髋臼内组织（左右径<0.9 cm，前后径<1.5 cm，面积<1.4 cm²）、髋关节内侧池间隙<6 mm、盂唇位置头位、无盂唇肥大内翻、股骨头h/b比率>0.1（同心复位）、股骨头颈前倾角<13°、股骨头灌注改变类型（A型）、无圆韧带延长肥厚、有骨化核显影、血管分型（Ⅲ型）、复位前牵引时间≥14 d、复位后固定时间≤6个月的患儿比例均高于效应无应答组（均P<0.05）。结论　临床应重视6～18月龄DDH患儿的相关影响因素，并进一步探索未知影响因素及各因素组合影响的深度和宽度，优化能有效治疗6～18月龄DDH患儿的针对性治疗方案。

关键词:

内容分析法, 发育性髋关节发育不良, 疗效相关因素, 髋人体位石膏外固定法, 适应证