应力性骨折的诊断试验评价  

EvaluationoftheDiagnosticTestsofStresFractures

作　　者：李祖国[1,2,3] 黄昌林[1,2,3] 李良寿[1,2,3] 李远贵[1,2,3] 邓敬兰[1,2,3] 陈友绩[1,2,3] 

机构地区：[1]解放军150医院骨科 [2]第四军医大学流行病学教研室 [3]第四军医大学西京医院核医学科

出　　处：《中华骨科杂志》1996年第4期241-244,共4页Chinese Journal of Orthopaedics

摘　　要：作者以核素骨扫描为金标准，用随机抽样、盲法检测、四格表法评价了Ｘ线摄影、红外线热成像、超声波诱痛试验和临床诊断检出应力性骨折的结果。Ｘ线检查了１３４个应力性骨折部位和１７９个对照部位，红外线热成像分别检查了１４６个和１６１个部位，超声波诱痛试验分别检查了７８个和６９个部位，临床诊断分别检查了２１７个和２４８３个部位。Ｘ线的灵敏度、特异度和符合率分别为１０％、１００％和６１％，红外线热成像分别为５６％、６７％和６２％，超声波诱痛试验分别７３％、４１％和６０％，临床诊断分别为７４％、９８％和９６％。作者认为针对新兵这一特殊的应力性骨折高发人群，临床医生只要对该损伤有足够的重视和认识，熟练掌握临床诊断标准，则可大大地提高对临床型应力性骨折诊断的正确性。所评价的３种非核素骨扫描诊断方法均不能替代核素骨扫描，为了寻找有效且简单易行的替代方法，尚需做进一步的研究。Usingbonescintigraphyasthegoldenstandard,theauthorsevaluatedthediagnosticre-sultsofradiography,thermography,ultrasoundinducedpaintestandclinicalfeaturesinthediagnosisofstressfractures.Randomsampling,blindmeasurementandfourfoldtablewereusedinthisstudy.134sitesofstressfracturesand179sitesofcontrolswereexaminedbyradiography,146stressfracturesand161sitesbythermogrophy,78stressfracturesand69sitesbyultrasoundinducedpaintestand217stressfracturesand2483sitesbyclinicalfeatures.thesensitivity(Se),specificity(Sp)andaccuracy(Ac)ofradiographywererespectively10%,100%,and61%;theSe,Sp,andAcofthermographywererespectively56%,67%,and62%;theSe,Sp,andAcofultrasoundinducedpaintestwerere-spectively73%,41%,and60%,andthoseofclinicaldiagnosiswere74%,93%and96%.Amongtherecruits,whichisaspecialgroupwithahighincidenceofstressfracture,themedicalpersonnelshouldpayenoughatentionforaccuracyofthediagnosisofstressfractures.Theevaluationofthethreeauxil-larydiagnosticmethodscouldnotreplacebonescintigraphyforthediagnosisofstressfractures.Newefortshouldbedonetomaketheauxilaryexaminationsimpleandeffective.

关 键 词：应力性 骨折 诊断试验 

分 类 号：R683.04[医药卫生—骨科学]