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目的:利用超声多元计数法替代X线诊断婴儿骨龄并应用于临床。方法:超声分别扫查42天、4个月、6个月、9个月、12个月组正常婴儿左侧踝、膝、髋、腕、肘、肩6个部位的相应14个标志性骨化中心(跟骨、距骨、骰骨、第三契骨、胫骨下、胫骨上、股骨下、股骨头、头状骨、钩骨、桡骨下、肱骨小头、肱骨头、大结节),每组男女各20例。以各年龄组中出现率≥50%的骨化中心定为该年龄组标志性骨化中心,计算其骨龄系数(骨龄系数:扫查见标志性骨化中心数/该年龄组标志性骨化中心数)及骨龄(骨龄=实际月龄×骨龄系数)。并将上述结果与X线标准分析对比。结果:B超标准各年龄组男组骨龄系数分别为(0.96±0.14),(0.98±0.15),(1.06±0.14),(1.02±0.10),(0.97±0.05);女组分别为(0.96±0.10),(0.99±0.09),(1.03±0.12),(0.98±0.08),(0.97±0.06);各相邻年龄组及各同年龄组男女相比均无显著性差异(P>0.05)。同年龄组B超标准与X线标准骨龄系数相比:42天组男女、9个月组女有极显著性差异(P<0.01),余均无显著性差异(P>0.05)。4个月组股骨头、6个月组肱骨小头、9个月组桡骨下、12个月组大结节为各年龄组B超重点标志骨化中心,且男女组无显著性差异(P>0.05)。结论:利用超声多元计数法诊断婴儿骨龄可客观评价婴儿骨龄,并可反复多次应用而无损伤性。引入骨龄系数概念有利于骨龄计算及本体与本体,本体与异体间的纵横向比较。此方法可用普通黑白B超操作,非常直观的计数方法评价使基层医务人员容易掌握,并用于指导临床。
OBJECTIVE: To diagnose infantile bone age by multi-count ultrasound instead of X-ray and to apply it in clinic. Methods: The corresponding 14 signs of the left ankle, knee, hip, wrist, elbow and shoulder of the normal infants at 42 days, 4 months, 6 months, 9 months and 12 months were scanned by ultrasound. (Calcaneus, talus, cuboid bone, third denticulation, tibial, tibial, femoral, femoral head, capitate, hookbone, radial, humeral head, humeral head, Each group of 20 men and women. The ossification center was defined as the central ossification center in the age group with ≥50% incidence, and the bone age index was calculated (skeletal age index: the number of marked ossification centers / landmark ossification in this age group Center number) and bone age (bone age = actual age × bone age coefficient). The above results were compared with the standard X-ray analysis. Results: The Bone age of boys in each age group was (0.96 ± 0.14), (0.98 ± 0.15), (1.06 ± 0.14), (1.02 ± 0.10) and (0.97 ± 0.05), respectively ± 0.10), (0.99 ± 0.09), (1.03 ± 0.12), (0.98 ± 0.08) and (0.97 ± 0.06), respectively. There was no significant difference between men and women in each adjacent age group and each age group (P> 0.05 ). Compared with the X-ray group, the B-level in the same age group had significant difference (P <0.01), but there was no significant difference in the 42-day group (P> 0.05). The femoral head in 4-month group, the small humeral head in 6-month group, the radial bone in 9-month group, and the nodules in 12-month group were the center of B-overweight sign in each age group, with no significant difference between men and women (P > 0.05). CONCLUSIONS: The use of multi-count ultrasound to diagnose infantile bone age can objectively evaluate the infant’s bone age, and can be repeatedly applied without damage. The introduction of the concept of skeletal age is conducive to the calculation of skeletal age and ontology and ontology, ontology and in vitro between the vertical and horizontal comparison. This method can be used ordinary black and white B-operation, a very intuitive evaluation of the counting method to make grassroots medical staff easy to grasp, and used to guide the clinical.