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首页> 外文期刊>Sao Paulo Medical Journal >Screening programmes for developmental dysplasia of the hip in newborn infants
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Screening programmes for developmental dysplasia of the hip in newborn infants

机译：新生儿髋部发育不良的筛查程序

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BACKGROUND Uncorrected developmental dysplasia of the hip (DDH) is associated with long term morbidity such as gait abnormalities, chronic pain and degenerative arthritis. OBJECTIVE To determine the effect of different screening programmes for DDH on the incidence of late presentation of congenital hip dislocation. METHODS Search methods: Searches were performed in CENTRAL (The Cochrane Library), MEDLINE and EMBASE (January 2011) supplemented by searches of clinical trial registries, conference proceedings, cross references and contacting expert informants. Selection criteria: Randomized, quasi-randomized or cluster trials comparing the effectiveness of screening programmes for DDH. Data collection and analysis: Three independent review authors assessed study eligibility and quality, and extracted data. MAIN RESULTS No study examined the effect of screening (clinical and/or ultrasound) and early treatment versus not screening and later treatment. AUTHORS' CONCLUSIONS There is insufficient evidence to give clear recommendations for practice. There is inconsistent evidence that universal ultrasound results in a significant increase in treatment compared to the use of targeted ultrasound or clinical examination alone. Neither of the ultrasound strategies have been demonstrated to improve clinical outcomes including late diagnosed DDH and surgery. The studies are substantially underpowered to detect significant differences in the uncommon event of late detected DDH or surgery. For infants with unstable hips or mildly dysplastic hips, use of delayed ultrasound and targeted splinting reduces treatment without significantly increasing the rate of late diagnosed DDH or surgery.
机译：背景技术未矫正的髋关节发育不良（DDH）与长期发病有关，例如步态异常，慢性疼痛和退行性关节炎。目的确定不同的DDH筛查方案对先天性髋关节脱位的晚期表现的影响。方法检索方法：在CENTRAL（Cochrane图书馆），MEDLINE和EMBASE（2011年1月）中进行了检索，并补充了临床试验注册资料，会议记录，对照资料和与专家联系的联系方式。选择标准：比较DDH筛查程序有效性的随机，半随机或聚类试验。数据收集和分析：三位独立评论作者评估了研究的资格和质量，并提取了数据。主要结果没有研究检查筛查（临床和/或超声）和早期治疗与未筛查和后期治疗的效果。作者的结论没有足够的证据给出明确的实践建议。不一致的证据表明，与单独使用定向超声或临床检查相比，通用超声导致治疗显着增加。超声策略均未显示可改善临床结果，包括晚期诊断DDH和手术。这项研究的能力很弱，无法检测到较晚发现的DDH或手术的罕见事件中的显着差异。对于髋部不稳定或髋部轻度异常增生的婴儿，延迟超声检查和针对性夹板的使用会减少治疗，而不会显着增加后期诊断DDH或手术的比率。

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