标题：肌骨超声在创伤性浅表软组织损伤中的应用

      作者：汤晓艳，吴伟涛，王琰，叶俊，张文    (青海省中医院功能科，青海 西宁 810001)

      卷次： 2017年28卷21期

      【摘要】 目的 探讨肌骨超声诊断创伤性浅表软组织损伤的应用价值，为肌骨超声的临床应用提供理论依据。方法 选择青海省中医院自2014年1月到2016年12月期间就诊的158例创伤性浅表软组织损伤患者为研究对象，分析所纳入患者创伤性浅表软组织损伤类型的构成情况。以手术结果为金标准，分析肌骨超声诊断软组织撕裂的敏感度、特异度和诊断符合率；比较肌骨超声和MRI诊断创伤性浅表软组织损伤的符合率。结果 腱鞘囊肿最为常见，有45例，占28.48%，其次为浅表性滑囊炎，有30例，占18.99%。以手术结果为金标准，肌骨超声诊断浅表软组织撕裂的敏感度为68.89%，特异度为78.57%，诊断符合率为71.19%。肌骨超声和MRI诊断韧带损伤、肌腱损伤以及肌肉损伤与手术的符合率均达 75%以上，其中超声诊断符合率分别为 83.33%、75.00%、75.00%，MRI诊断符合率分别为 88.89%、75.00%、75.00%，两者比较，韧带损伤符合率的差异均无统计学意义(均P>0.05)；超声诊断半月板损伤的符合率为 42.86%，显著低于MRI诊断半月板损伤的符合率(85.71%)，差异有统计学意义(P<0.05)。结论 肌骨超声诊断创伤性浅表软组织损伤有较高的准确性，具有无创、可重复性强、可动态比较等优势，可作为创伤性浅表软组织损伤的常规检查措施。
      【关键词】 肌骨超声；创伤性浅表软组织损伤；应用价值
      【中图分类号】 R445.1 【文献标识码】 A 【文章编号】 1003—6350（2017）21—3510—04

Application of musculoskeletal ultrasoun in the treatment of traumatic superficial soft tissue injury.
TANGXiao-yan, WU Wei-tao, WANG Yan, YE Jun, ZHANG Wen. Department of Function, Qinghai Provincial Hospital ofTraditional Chinese Medicine, Xining 810001, Qinghai, CHINA
【Abstract】 Objective To investigate the application value of musculoskeletal ultrasoun in the diagnosis of trau-matic superficial soft tissue injury. Methods A total of 158 patients with superficial soft tissue injury, who admitted toDepartment of Function of Qinghai Provincial Hospital of Traditional Chinese Medicine from January 2014 to Decem-ber 2016, were selected as the subjects to analyze the composition of traumatic superficial soft tissue injury in the pa-tients. The sensitivity, specificity and diagnostic accordance rate of ultrasound diagnosis of soft tissue laceration were an-alyzed with the results of surgery as the gold standard, and the coincidence rate of the diagnosis of superficial soft tissueinjury was compared with that of bone marrow and MRI. Results Ganglion cysts were the most common (45 cases,28.48%), followed by superficial bursitis in 30 cases (18.99%). Taking the operation results as the gold standard, the sen-sitivity, specificity, diagnostic coincidence rate of musculoskeletal ultrasound in the diagnosis of superficial soft tissuetearing were respectively 68.89%, 78.57%, 71.19%. The coincidence rates of musculoskeletal ultrasound and MRI diag-nosis of ligament, tendon and muscle injury and surgery coincidence rate were above 75%; the coincidence rates of ultra-sonography were 83.33%, 75.00% and 75.00% respectively; the coincidence rates of MRI were 88.89%, 75.00% and75.00% respectively; there was no significant difference in the coincidence rate of ligament injury in the two groups (P>0.05). The coincidence rate of ultrasound diagnosis of meniscus injury was 42.86%, which was significantly lower than85.71% of MRI (P<0.05). Conclusion Musculoskeletal ultrasound has the high accuracy in the diagnosis of traumaticsuperficial soft tissue injury, which also has advantages of noninvasive, repeatability and dynamic comparison. It can beused as a routine measure for traumatic superficial soft tissue injury.
      【Key words】 Musculoskeletal ultrasound; Traumatic superficial soft tissue injury; Application value·论 著·doi:10.3969/j.issn.1003-6350.2017.21.023基金项目：青海省西宁市科技计划项目（编号：2016015036）