背景与目的：超声Graf法为婴儿发育性髋关节发育不良（DDH）的有效诊断方法，而体格检查为早期DDH最常用的筛查方法，本文旨在探讨应用超声评估体格检查在DDH中的早期诊断价值。方法：对631例在内蒙古各医院行体检发现DDH阳性体征（臀纹不对称、腿纹不对称、髋关节外展受限、髋关节弹响、双下肢不等长）而转诊到我院或至我院进行DDH常规筛查的婴儿行体格检查，受检婴儿根据超声检查分型分为DDH组（Ⅱ～ Ⅳ型）与正常髋关节组（Ⅰ型），分析性别、月龄、生产方式、胎位及体格检查各阳性体征与DDH的关系，比较各阳性体征群体中DDH分型的构成比差异。结果：631例婴儿中超声检出DDH患儿48例，DDH检出率为7.6%。单因素及多因素回归分析显示性别（OR=1.973，95%置信区间：1.023-3.806，p=0.043）、髋关节弹响（OR=3.932，95%置信区间：1.458-10.608，p=0.007）及双下肢不等长(OR=12.018,95%置信区间：4.056-35.609，p＜0.001)为患DDH的独立危险因素。各阳性体征与DDH分型之间构成比差异无统计学意义（H=3.953，p=0.412)。结论：体格检查对早期DDH筛查具有重要的临床价值，髋关节弹响与双下肢不等长婴儿患DDH风险增高，结合Graf超声检查为可为早期诊断DDH提供较大的帮助。

Background and Objective Ultrasonic Graf is an effective method for the diagnosis of (DDH) in infants with Developmental Dysplasia of Hip, and physical examination is the most commonly used screening method for early DDH. The purpose of this paper is to explore the value of physical examination in the early diagnosis of DDH.Methods A total of 631 infants with DDH positive signs ( the Asymmetrical thigh creases、the Asymmetrical hip creases、the Limitation of hip abduction、the Clicky Hip、the Leg Length Discrepancy) were transferred to our hospital for routine DDH screening for physical examination. The infants were divided into DDH group (typeⅡ~ IV) and normal hip joint group (type I) according to ultrasonic examination. The relationship between sex, age, mode of production, fetal position, physical examination and DDH was analyzed, and the constituent ratio of DDH typing in each positive sign population was compared.Results Among the 631 infants, 48 cases of DDH were detected by ultrasound, and the positive rate of DDH was 7.6%. Univariate and multivariate regression analysis showed that gender（OR=1.973，95%CI：1.023-3.806，p=0.043）, the Clicky Hip （OR=3.932，95%CI：1.458-10.608，p=0.007） and the Leg Length Discrepancy(OR=12.018,95%CI：4.056-35.609，p＜0.001) were independent risk factors for DDH. There was no significant difference in the constituent ratio between the positive signs and the DDH classification（H=3.953，p=0.412).Conclusion Physical examination has important clinical value for early DDH screening. Infants with the Clicky Hip and the Leg Length Discrepancy have an increased risk of DDH. Combined with Graf ultrasound examination can provide great help for early diagnosis of DDH.

内蒙古自治区科技计划项目（2019GG111） 内蒙古自治区科技成果转化项目（CGZH2018148） 内蒙古卫生健康领域应用技术研发项目（201802157）