放射性核素骨显像诊断人工关节置换后假体感染的临床研究  

Clinical effect of radionuclide bone imaging in diagnosis of prosthesis infections after hip replacement

作　　者：尚毓[1] 于淑芬[2] 王池平[1] 

机构地区：[1]南阳市中心医院核医学科,河南南阳473000 [2]南阳市第二人民医院心电图室,河南南阳473000

出　　处：《中华医院感染学杂志》2014年第12期3024-3026,共3页Chinese Journal of Nosocomiology

基　　金：南阳市卫生局基金资助项目(HN-2010A-047)

摘　　要：目的探讨放射性核素骨显像诊断人工关节置换后假体感染的临床效果,以期提高临床治疗水平。方法回顾性分析2011年3月-2013年2月55例人工关节置换后假体感染患者,将其分为对照组27例予以MRI检查诊断,观察组28例予以放射性核素骨显像诊断,比较两组患者在诊断上的差异;采用SPSS13.0软件进行数据统计分析。结果对照组患者轻度感染8例、中度13例,感染率分别为29.63%、48.15%,观察组患者轻度感染19例、中度4例,感染率分别为67.83%、14.29%,两组患者比较,差异有统计学意义(P<0.05);敏感性、特异性、阳性预测值、阴性预测值对照组患者分别为48.15%、88.89%、51.85%、48.15%,而观察组分别为82.14%、29.29%、78.27%、75%,两组比较差异有统计学意义(P<0.05);而对照组在假体下沉、假体松动、骨溶解、骨膜反应、内固定不稳等影像学上则较观察组明显,差异有统计学意义(P<0.05)。结论放射性核素骨显像诊断人工关节置换后假体感染价值高。OBJECTIVE To explore the clinical effect of radionuclide bone imaging in diagnosis of prosthesis infections after hip replacement so as to improve the level of clinical treatment .METHODS A total of 55 patients with prosthesis infections who underwent the hip replacement from Mar 2011 to Feb 2013 were enrolled in the study and divided into the control group with 27 cases and the observation group with 28 cases ,then the control group was treated with MRI examination for diagnosis ,the observation group was given the radionuclide bone imaging for diagnosis ,the clinical effect was observed and compared between the two examination methods ,and the statistical analysis was performed with the use of SPSS 13 .0 software .RESULTS There were 8 （29 .63% ） cases of mild infection and 13 （48 .15% ） cases of moderate infections in the control group ;there were 19 （67 .83% ） cases of mild infections and 4 （14 .29% ） cases of moderate infections in the observation group ,the differences between the two groups were significant（P〈0 .05） .The sensitivity was 48 .15% in the control group ,82 .14% in the observation group ;the specificity was 88 .89% in the control group ,29 .29% in the observation group ;the positive predictive value was 51 .85% in the control group ,78 .27% in the observation group . The negative predictive value was 48 .15% in the control group ,75% in the observation group ,the differences between the two groups were significant （P〈0 .05） .As compared with the prosthesis sinking ,prosthesis loosening ,osteolysis , periosteal reaction ,or unstable internal fixation ,the difference between the control group and the observation group was significant（P〈0 .05） .CONCLUSIONS The radionuclide bone imaging has significant value in diagnosis of the prosthesis infections after the hip replacement .

关 键 词：放射性核素 人工关节置术 假体感染 临床价值 

分 类 号：R181.32[医药卫生—流行病学]