基于信息上报系统的无锡地区2015—2017年度婴幼儿髋关节筛查总结
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摘要
目的:探讨无锡地区婴幼儿髋关节筛查信息上报系统在婴幼儿髋关节普遍筛查中的应用及相关数据分析。方法:将婴幼儿髋关节筛查内容、评价标准、治疗指导意见整合进一张表格,依托无锡市人民医院医联体,建立一套髋关节发育不良(developmental dysplasia of the hip,DDH)上报系统,对部分医院辐射范围内的所有出生6周的婴儿采用Graf超声筛查法检查髋关节,将收集的数据上传至婴幼儿髋关节筛查登记系统,依据系统指导意见,对可疑患儿进行随诊或转诊。将所获数据进行统计分析,评价该信息化上报系统对髋关节筛查的效果。结果:2015年1月至2017年4月6 094例婴儿实施髋关节Graf超声筛查,依据系统指导意见,随诊44例,36例转至无锡市儿童医院,17例确诊为DDH。结论:该信息上报系统可以有效地监测婴幼儿髋关节发育情况,精简上报流程,并且依据系统提供的指导意见可以减小人为误差,使治疗意见更为规范、客观,同时也让研究者更容易监测和收集髋关节发育信息。婴幼儿髋关节筛查信息化上报系统用于筛查婴幼儿髋关节切实可行,对髋关节的治疗和随访具有指导意义,但是在实施过程中需政府医保部门的大力支持。
Objective: To explore the application of the information system of infant hip joint screening in wide range screening of hip joint in children and to analyze the related data. Methods: The infant hip screening content, evaluation criteria, treatment guidance integrated into a form, relying on the Wuxi People's Hospital Medical Association, to establish a set of developmental dysplasia of the hip(DDH) reporting system, all children within 6 weeks old serviced by hospital were examined by Graf ultrasonography for hip joint examination, upload data to the registration system,interventions for suspected children were conducted on the basis of systematic guidelines. The data obtained were statistically analyzed, and the effect of the information reporting system on the hip joint screening was evaluated. Results: From January 2015 to April 2017, 6 094 infants underwent Graf ultrasound screening of the hip. According to the guidance of the system, 44 cases were followed up, 36 cases were transferred to Wuxi Children's Hospital, and 17 cases were diagnosed as DDH. Conclusion: The information reporting system can effectively monitor the development of the hip joint in infants, streamlining the layers of reporting process, and based on the guidance provided by the system can reduce human error, make the treatment more standardized and objective views. It also allows researchers monitor and collect the information of hip dysplasia more easily. The information reporting system of infant hip joint screening is practicable to screen the hip joint of infants and children. It is of guiding significance to the treatment and follow-up of the hip joint. However, the government medical insurance department should support it in the process of operation.
Objective: To explore the application of the information system of infant hip joint screening in wide range screening of hip joint in children and to analyze the related data. Methods: The infant hip screening content, evaluation criteria, treatment guidance integrated into a form, relying on the Wuxi People's Hospital Medical Association, to establish a set of developmental dysplasia of the hip(DDH) reporting system, all children within 6 weeks old serviced by hospital were examined by Graf ultrasonography for hip joint examination, upload data to the registration system,interventions for suspected children were conducted on the basis of systematic guidelines. The data obtained were statistically analyzed, and the effect of the information reporting system on the hip joint screening was evaluated. Results: From January 2015 to April 2017, 6 094 infants underwent Graf ultrasound screening of the hip. According to the guidance of the system, 44 cases were followed up, 36 cases were transferred to Wuxi Children's Hospital, and 17 cases were diagnosed as DDH. Conclusion: The information reporting system can effectively monitor the development of the hip joint in infants, streamlining the layers of reporting process, and based on the guidance provided by the system can reduce human error, make the treatment more standardized and objective views. It also allows researchers monitor and collect the information of hip dysplasia more easily. The information reporting system of infant hip joint screening is practicable to screen the hip joint of infants and children. It is of guiding significance to the treatment and follow-up of the hip joint. However, the government medical insurance department should support it in the process of operation.
引文
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2.曹隽,孙琳,高荣轩,等.2009-2012年北京市2118例发育性髋关节发育不良筛查工作中体格检查的可靠性分析[J].北京医学2015,37(6):513-516.CAO Jun,SUN Lin,GAO Rongxuan,et al.The reliability study of physical examination in developmental dysplasia of the hip screening in2009-2012:summary of 2118 screening cases in Beijing[J].Beijing Medical,2015,37(6):513-516.
3.吕学敏,郭源,边臻,等.婴儿发育性髋关节发育不良自然发育过程研究[J].中华小儿外科杂志,2014,35(11):848-852.LüXuemin,GUO Yuan,BIAN Zhen,et al.Natural progress of infantile developmental dysplasia of hip[J].Chinese Journal of Pediatric Surgery,2014,35(11):848-852.
4.Thallinger C,Pospischill R,Ganger R,et al.Long-term results of a nationwide general ultrasound screening system for developmental disorders of the hip:the Austrian hip screening program[J].J Child Orthop,2014,8(1):3-10.
5.Laborie LB,Markestad TJ,Davidsen H,et al.Selective ultrasound screening for developmental hip dysplasia:effect on management and late detected cases.A prospective survey during 1991-2006[J].Pediatr Radiol,2014,44(4):410-424.
6.刘秋亮,王义生,刘玉峰,等.新生儿与婴幼儿髋关节发育不良的院内筛查[J].中国骨与关节杂志,2016,5(7):483-486.LIU Qiuliang,WANG Yisheng,LIU Yufeng,et al.Screening of developmental dysplasia of the hip in infants and young children in hospital[J].Chinese Journal of Bone and Joint,2016,5(7):483-486.
7.中华医学会小儿外科分会骨科学组.发育性髋关节发育不良临床诊疗指南(0~2岁)[J].中华骨科杂志,2017,37(11):641-650.Department of Orthopaedic Sciences,Pediatric Surgery Branch Chinese Medical Association.Clinical Guidelines for Diagnosis and Treatment of Developmental Hip Dysplasia(0-2 years old)[J].Chinese Journal of Orthopaedics,2017,37(11):641-650.
8.Wientroub S,Grill F.Ultrasonography in developmental dysplasia of the hip[J].J Bone Joint Surg Am,2000,82-A(7):1004-1018.
9.Dorn U,Neumann D.Ultrasound for screening developmental dysplasia of the hip:a European perspective[J].Curr Opin Pediatr2005,17(1):30-33.
10.Wenger DR,Varley ES.Evidence-based orthopaedics:the best answers to clinical questions[J].J Pediatr Orthop,2009,29(7):835-836.
11.Pediatric Orthopedics:Tachdjian’s Pediatric Orthopaedics,vols 1-3[J]JAMA,2002,288(6):771.
12.Graf R,Scott S.Hip sonography:diagnosis and management of infant hip dysplasia[M].Heidelberg:Springer-Verlag Berlin Heidelberg,2006
13.黄杰,林小影,李功祥,等.超声筛查发育性髋关节发育不良高危婴儿的临床价值[J].临床超声医学杂志,2016,34(12):845-847.HUANG Jie,LIN Xiaoying,LI Gongxiang,et al,Clinical value of ultrasound screening high risk infants with developmental dysplasia of hip[J].Practical Journal of Medicine&Pharmacy,2016,34(12):845-847.
14.Muller GM,Seddon HJ.Late results of treatment of congenital dislocation of the hip[J].J Bone Joint Surg Br,1953,35-B(3):342-362.
2.曹隽,孙琳,高荣轩,等.2009-2012年北京市2118例发育性髋关节发育不良筛查工作中体格检查的可靠性分析[J].北京医学2015,37(6):513-516.CAO Jun,SUN Lin,GAO Rongxuan,et al.The reliability study of physical examination in developmental dysplasia of the hip screening in2009-2012:summary of 2118 screening cases in Beijing[J].Beijing Medical,2015,37(6):513-516.
3.吕学敏,郭源,边臻,等.婴儿发育性髋关节发育不良自然发育过程研究[J].中华小儿外科杂志,2014,35(11):848-852.LüXuemin,GUO Yuan,BIAN Zhen,et al.Natural progress of infantile developmental dysplasia of hip[J].Chinese Journal of Pediatric Surgery,2014,35(11):848-852.
4.Thallinger C,Pospischill R,Ganger R,et al.Long-term results of a nationwide general ultrasound screening system for developmental disorders of the hip:the Austrian hip screening program[J].J Child Orthop,2014,8(1):3-10.
5.Laborie LB,Markestad TJ,Davidsen H,et al.Selective ultrasound screening for developmental hip dysplasia:effect on management and late detected cases.A prospective survey during 1991-2006[J].Pediatr Radiol,2014,44(4):410-424.
6.刘秋亮,王义生,刘玉峰,等.新生儿与婴幼儿髋关节发育不良的院内筛查[J].中国骨与关节杂志,2016,5(7):483-486.LIU Qiuliang,WANG Yisheng,LIU Yufeng,et al.Screening of developmental dysplasia of the hip in infants and young children in hospital[J].Chinese Journal of Bone and Joint,2016,5(7):483-486.
7.中华医学会小儿外科分会骨科学组.发育性髋关节发育不良临床诊疗指南(0~2岁)[J].中华骨科杂志,2017,37(11):641-650.Department of Orthopaedic Sciences,Pediatric Surgery Branch Chinese Medical Association.Clinical Guidelines for Diagnosis and Treatment of Developmental Hip Dysplasia(0-2 years old)[J].Chinese Journal of Orthopaedics,2017,37(11):641-650.
8.Wientroub S,Grill F.Ultrasonography in developmental dysplasia of the hip[J].J Bone Joint Surg Am,2000,82-A(7):1004-1018.
9.Dorn U,Neumann D.Ultrasound for screening developmental dysplasia of the hip:a European perspective[J].Curr Opin Pediatr2005,17(1):30-33.
10.Wenger DR,Varley ES.Evidence-based orthopaedics:the best answers to clinical questions[J].J Pediatr Orthop,2009,29(7):835-836.
11.Pediatric Orthopedics:Tachdjian’s Pediatric Orthopaedics,vols 1-3[J]JAMA,2002,288(6):771.
12.Graf R,Scott S.Hip sonography:diagnosis and management of infant hip dysplasia[M].Heidelberg:Springer-Verlag Berlin Heidelberg,2006
13.黄杰,林小影,李功祥,等.超声筛查发育性髋关节发育不良高危婴儿的临床价值[J].临床超声医学杂志,2016,34(12):845-847.HUANG Jie,LIN Xiaoying,LI Gongxiang,et al,Clinical value of ultrasound screening high risk infants with developmental dysplasia of hip[J].Practical Journal of Medicine&Pharmacy,2016,34(12):845-847.
14.Muller GM,Seddon HJ.Late results of treatment of congenital dislocation of the hip[J].J Bone Joint Surg Br,1953,35-B(3):342-362.