Avtor/Urednik		Golob-Tekauc, A; Tomažič, Tomaž; Japelj, I
Naslov		Ultrazvočni pregledi kolkov pri novorojenčku - pregled 13 letnih izkušenj
Prevedeni naslov		Ultrasound examination of the hips in the newborn - 13 years of experiences
Tip		članek
Vir		Slov Pediatr
Vol. in št.		Letnik 5, št. Suppl 2
Leto izdaje		1998
Obseg		str. 118-22
Jezik		slo
Abstrakt		Aim: Ultrasonic visualization of the hips in neonates and infants has been employed in Maribor since 1985. In 1988 ascrening programme was implemented. The aim of the present study was to analyse the results of this programme. Methods: 24,517 children underwent ultrasonic examination during the 13-year period. The morbidity of 10,832 children, born between 1993-1997, was analysed. The average annual number of aggressive conservative and surgical interventions for dislocation of the hip was comapred for the three periods. 1960-1984 /clinical examination only/, 1985-1987 /ultrasaund in at-risk group/ and 1988-1995 /ultrasaund screening/. Results: Of 21,664 sonographically evaluated hips, 78% were mature at the initial examination, 20% were type II a /according to Graf classification/ and 2% were unstable. Girls were more frequently affected than boys /3.7 : 1/ and the right hip was more frequently affected than left /1.11:1/. 81,7% of babies underwent their final examination at 12 weeks, 13.8% at 20 weeks and only 4,5% required former treatment after 20 weeks of age. There was an eightfold derease inthe need for conservative intervention and a tenfold decrease in the need for surgical treatment of dislocated hips. Conclusion: The most important contribution of ultrasonic screening of the hips in early childhood is the early diagnosis of the immature hip, leading to early, non-aggressive adequate treatment. Treatment has changed significantly, with both aggressive conservative and surgical treatment being dramatically decreased.
Izvleček		Izhodišča: V mariborski porodnišnici smo leta 1985 začeli ultrazvočno preiskovati kolke pri otrocih z anamnestičnim in kliničnim tveganjem. Od leta 1988 smo prešli na presajalne preglede kolkov pri vseh novorojenčkih. Namen raziskave je bil oceniti rezultate presejanja. Metode: V 13 letih smo pri 24517 otrocih z ultrazvokom pregledali 49034 kolkov že v porodnišnici. Za statistično oceno smo izbrali vzorec 10832 pregledanih otrok v obdobju 1993-1997. Primerjali smo letno število potrebnih agresivnih nekrvavih in operativnih posegov v treh obdobjih: 1960 - 84 (klinični pregledi, rentgenske preiskave), 1985-87 (ultrazvok rizične skupine otrok) in 1988-1997 (ultrazvočno presejanje). Poiskali smo morebitno dodatno obolevnost operiranih otrok. Rezultati: Od 21664 pregledanih kolkov je bilo pri prvem pregledu 78% kolkov zrelih, 20% fiziološko nezrelih in 2% nezrelih kolkov. Pri 81,7% otrok je bil zadnji pregled opravljen do 12. tedna starosti, pri 13,8% do 20. tedna in le 4,5% otrok je po tej starosti še potrebovalo kontrolne preglede in zdravljenje. Število operativnih posegov je osemkrat manjše in število vseh agresivnih psegov desetkrat manjše kot v času pred presejanjem. Velik delež (65%) operativnih posegov je bil opravljen zaradi dodatnih bolezni mišično-živčnega sklopa pri otrocih. Zaključki: Ultrazvočno presajanje kolkov je pomemben prispevek k zgodnjemu ugotavljanju nepravilnosti v razvoju otroškega kolka, ker omogoča zgodnje ustrezno zdravljenje, ki večinoma ni agresivno. Število vendarle potrebnih agresivnih posegov se je po uvedbi presejanja in zgodnjih neagresivnih ukrepov dramatično zmanjšalo.
Deskriptorji		HIP JOINT HIP DISLOCATION, CONGENITAL INFANT, NEWBORN MASS SCREENING AGE FACTORS