超声引导技术在假体周围穿刺中的应用价值研究  

Study on application value of ultrasound guided technique in peripheral prosthesis puncture

作　　者：李文波[1] 方心俞[1] 白国昌[1] 陈勐 陈树强[2] 张文明[1] LI Wenbo;FANG Xinyu;BAI Guochan;CHEN meng;CHEN Shuqiang;ZHANG Wenming(Department of Joint Surgery,the First Affiliated Hospital of Fufian Medical University,Fuzhou 350001,China;Department of Ultrasound Branch,the First Affiliated Hospital of Fujian Medical University,Fuzhou 350001,China)

机构地区：[1]福建医科大学附属第一医院关节外科,福建福州350001 [2]福建医科大学附属第一医院超声科,福建福州350001

出　　处：《中国现代医生》2018年第18期98-100,103,共4页China Modern Doctor

基　　金：福建省自然科学基金对外合作项目(2018I0006);福建省自然科学基金高校产学合作项目(2018Y4003)

摘　　要：目的探讨超声引导下穿刺在假体周围抽取关节液的应用价值。方法将需行髋关节假体周围穿刺的病例随机分为A组和B组,A组为传统的C臂透视引导下穿刺,B组为超声引导下穿刺;同时将需行人工膝关节假体周围穿刺的病例随机分为C组和D组,C组为盲穿法,D组为超声引导下穿刺。每个病例记录是否取得关节液,获取关节液量,穿刺次数,关节液是否混有血液。结果在人工髋关节周围穿刺,A组8例患者中有3例穿刺获取关节液,成功率为37.5%,B组10例患者中9例穿刺获取关节液,成功率为90.0%;A组平均穿刺(4.8±1.2)次,B组平均穿刺(6.1±1.2)次,两组对比有显著性差异(P<0.01);B组抽的关节液量(6.1±1.2)mL也较A组(2.4±0.4)mL多,两组对比有显著性差异(P<0.05)。膝关节组C组13例患者中有8例穿刺获取关节液,成功率为61.5%,D组11例患者中全部穿刺获取关节液,成功率为100.0%,两组对比具有显著性差异(P<0.01);C组平均穿刺(2.5±0.9)次,D组平均穿刺(6.1±1.2)次,两组对比有显著性差异(P<0.01);C组抽的关节液量(4.6±0.9)mL,也较D组(8.7.4±5.0)mL多,两组对比具有显著性差异(P<0.01)。结论超声引导下穿刺可作为人工关节周围穿刺获取关节液的首选方法。Objective To evaluate the value of ultrasound-guided puncture in the extraction of joint fluid around the prosthesis. Methods Randomly divided the cases that need to be punctured around hip prosthesis into group A and group B. Group A took the traditional C-arm fluoroscopy-guided puncture, and group B took the ultrasound-guided puncture; at the same time, the patients requiring peripheral puncture of artificial knee joints were randomly divided into groups C and D. C group took blind puncture, and group D was ultrasound-guided puncture. Each case records whether synovial fluid was obtained, the amount of fluid in the joint, the number of punctures and whether the synovial fluid was mixed with blood. Results Peripheral puncture was performed around the hip joint. Three of the eight patients in group A had punctures to obtain synovial fluid with a success rate of 37.5%. In group B, 10 of 10 patients had punctures to obtain synovial fluid with a success rate of 90.0%. The average puncture times in group A was（4.8±1.2）times, average puncture times in group B was（6.1±1.2）, there was significant difference between the two groups（P〈0.01）; the amount of joint fluid（6.1±1.2） mL in group B was also higher than group A：（2.4±0.4）mL, there was a significant dif- ference between the two groups（P〈0.05）. Eight of 13 patients in group C of the knee group received puncture for synovial fluid with a success rate of 61.5%. All 11 patients in group D received puncture for synovial fluid with a success rate of 100.0%. There was a significant difference between the two groups （P〈0.01）. The average puncture in group C was （2.5±0.9） times, and the average puncture times in group D was（6.1±1.2）times. There was significant difference between the two groups（P〈0.01）; the amount of joint fluid extracted in group C was（4.6±0.9） mL. It was also more than group D （8.7.4±5.0）mL, there was a significant difference between the two groups （P〈0.01）. Conclusion Ultrasound-guided p

关 键 词：超声 人工关节 假体感染 穿刺 关节液 

分 类 号：R445.1[医药卫生—影像医学与核医学]