标题：儿童髋关节一过性滑膜炎的临床特点及诊治分析

      作者：聂淼桔，俞松，吕欣    遵义医科大学附属医院小儿矫形外科，贵州 遵义 563003

      卷次： 2021年32卷4期

      【摘要】 目的 总结儿童髋关节一过性滑膜炎(TSH)的临床特点，进一步提高对该病的诊治水平。方法 回顾性分析2010年1月至2019年12月于遵义医科大学附属医院小儿矫形外科治疗的1 054例入院诊断为髋关节性滑膜炎患儿的临床资料并分析其特点。结果 1 054例中最终确诊967例，其中男性702例，女性265例，男女发病数量比较差异具有统计学意义(P<0.05)；患儿年龄0.5~14岁，平均年龄(5.6±3.1)岁；170例有呼吸道感染病史，39例有外伤史，18例有剧烈活动病史，1例有腮腺炎病史；秋季多见，4月、9月为发病高峰；实验室检查多数患儿表现为淋巴细胞及单核细胞计数的增加，超声及MRI检查多提示髋关节积液、滑膜增厚及软组织肿胀；单髋发病917例，双髋发病50例。患儿主要表现为髋关节疼痛伴跛行(555例)，部分可仅表现为跛行(150例)或伴大腿或膝关节的疼痛(108例)，少数可仅表现为髋关节疼痛(73例)或伴下肢拒绝承重(67例)，极少数仅表现为大腿或膝关节疼痛(14例)，所有患者均出现不同程度的髋关节活动受限。结论 儿童TSH好发学龄前期，男性多见，单侧发病较多，主要表现为不同程度的髋关节疼痛、活动受限、患肢乏力及跛行，治疗上主要以卧床休息及患肢牵引制动为主。
      【关键词】 儿童；髋关节；一过性滑膜炎；临床特点；诊治
      【中图分类号】 R726 【文献标识码】 A 【文章编号】 1003—6350（2021）04—0488—03

Clinical characterization, diagnosis and treatment of transient synovitis of the hip in children.
NIE Miao-jie, YUSong, LV Xin. Department of Pediatric Orthopedic Surgery, Affiliated Hospital of Zunyi Medical College, Zunyi 543003,Guizhou, CHINA
【Abstract】 Objective To analyze the characteristics of transient synovitis of the hip (TSH) in children, and toincrease the diagnosis and treatment level of this disease. Methods The medical records of children admitted to Depart-ment of Pediatric Orthopedic Surgery, Affiliated Hospital of Zunyi Medical College for transient synovitis of the hip be-tween 2010 and 2019 were retrospectively reviewed. Related clinical data, including gender, age, pathogeny, clinical mani-festation, laboratory and imaging data, diagnosis and treatment were obtained. Results A total of 1 054 patients were in-cluded. TSH was diagnosed in 702 boys and 265 girls (P<0.05). The age of the patients ranged from 6 months to 14 years,with an average of (5.6±3.1) years. A total of 170 patients had a previous upper respiratory infection, 39 patients had trau-ma, 18 patients had strenuous activities, and one patient had mumps. Incidence of TSH was mainly occurred during au-tumn with peaks in April and September. Laboratory findings revealed that most patients had lymphocytosis and mononu-cleosis. The common indications of ultrasonography and MRI were hip joint effusion, synovial thickening, and soft tissueswelling. The single hip was involved in 917 patients and the bilateral hip in 50 patients. TSH patients typically presentedwith an acute onset of groin pain and a limp (555 cases), and some cases may only presented with claudication (150 cases)or with thigh or knee joint pain (108 cases), a few only manifested as hip pain (73 cases) or accompanied by refusal to bearweight on the lower extremity (67 cases), and a very small number of children only showed pain in the thigh or knee (14cases), with limited passive range of motion upon manipulation. Conclusion TSH is more common in preschool-age chil-dren and in males. It is mainly unilateral, and its main clinical manifestations are groin pain, limitation of movement, alimp and an unwillingness to bear weight. The main treatment is bed rest and traction.
      【Key words】 Children; Hip joint; Transient synovitis of the hip (TSH); Clinical characterization; Diagnosis andtreatment·短篇论著·doi:10.3969/j.issn.1003-6350.2021.04.022基金项目：贵州省科学技术基金项目(编号：黔科合J字LKZ[2013]48号)；贵州省遵义市汇川区科技计划项目