麦氏试验对半月板损伤和膝关节间隙内疾病的诊断价值比较
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作者Author单位AddressE-Mail
田野 TIAN Ye 中国医科大学附属盛京医院第一骨外科,辽宁沈阳110004 The First Department of Orthopaedics,the Second Affiliated Hospital to China Medical University,Shenyang 110004,Liaoning,China xxyy0402@sina.com.cn 
白伦浩 BAI Lun-hao 中国医科大学附属盛京医院第一骨外科,辽宁沈阳110004 The First Department of Orthopaedics,the Second Affiliated Hospital to China Medical University,Shenyang 110004,Liaoning,China  
付勤 FU Qin 中国医科大学附属盛京医院第一骨外科,辽宁沈阳110004 The First Department of Orthopaedics,the Second Affiliated Hospital to China Medical University,Shenyang 110004,Liaoning,China  
期刊信息:《中国骨伤》2007年,第20卷,第11期,第736-738页
DOI:doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz
基金项目:
中文摘要:

目的:回顾性分析281例膝关节疾患的患者麦氏试验及关节镜检查结果,比较麦氏试验对半月板损伤和膝关节间隙内疾病的诊断价值。

方法:膝关节疾患患者281例,男163例,女118例;年龄14~78岁,平均41.6岁;病程4d~10年。患者均表现有不同程度的膝关节疾患的症状或体征;对患者进行麦氏试验检查和膝关节镜下的探查和治疗;以关节镜检查作为黄金标准,分别以麦氏试验对半月板损伤和膝关节间隙内疾病的诊断价值,与关节镜检查结果对照,进行四格表法分析的统计学评估,并对两组数据进行比较。

结果:281例患者,麦氏试验阳性者126例,阴性者155例。在麦氏试验阳性者中,半月板损伤者67例,非半月板损伤者59例;在麦氏试验阴性者中,半月板损伤者14例,非半月板损伤者141例;麦氏试验对半月板损伤的诊断的敏感度为83%,特异度为71%,阳性预测值为53%,阴性预测值为91%。在麦氏试验阳性者中,膝关节间隙内疾病者121例,非膝关节间隙内疾病者5例;在麦氏试验阴性者中,膝关节间隙内疾病者35例,非膝关节间隙内疾病者120例;麦氏试验对膝关节间隙内疾病诊断的敏感度为78%,特异度为96%,阳性预测值为96%,阴性预测值为77%。

结论:麦氏试验对半月板损伤的诊断具有一定的局限性,对膝关节间隙内疾病的诊断具有很高的特异性,如麦氏试验阳性,则高度怀疑膝关节间隙内存在病变,但麦氏试验阴性,不能排除膝关节间隙内无病变存在。
【关键词】麦氏试验  半月板  胫骨  损伤  膝关节  诊断
 
Comparison the diagnostic values of McMurray’s test between a meniscus injury and a disease in the knee space
ABSTRACT  

Objective:To compare the diagnostic values of McMurray’s test between a meniscus injury and a disease in the knee space.

Methods:Two hundreds and eighty-one patients(163 males and 118 females;an average age of 41.6 years ranging from 14 to 78 years;a duration ranging from 4 days to 10 years;with some clinical symptoms and signs of a disease in the knee space) suffering knee diseases had the McMurray’s test and the arthroscopic operation.The arthroscopic findings were regarded as the golden standard.The diagnostic values of McMurray’s test for a meniscus injury and a disease in the knee space were assessed statistically according to the fourfold table and were compared.

Results:In the 281 patients,there were 126 cases with McMurray’s test positive and 155 cases with McMurray’s test negative.In the patients with McMurray’s test positive,there were 67 cases with a meniscus injury and 59 cases with no meniscus injury;In the patients with McMurray’s test negative,there were 14 cases with a meniscus injury and 141 cases with no meniscus injury;With McMurray’s test for a meniscus injury,the sensitivity was 83%,the specificity was 71%,the positive predictive value was 53% and the negative predictive value was 91%.In the patients with McMurray’s test positive,there were 121 cases with a disease in the knne space and 5 cases with no disease in the knee space;In the patients with McMurray’s test negative,there were 35 cases with a disease in the knee space and 120 cases with no disease in the knee space;With McMurray’s test for a disease in the knee space,the sensitivity was 78%,the specificity was 96%,the positive predictive value was 96% and the negative predictive value was 77%.

Conclusion:The diagnosis of McMurray’s test for a meniscus injury is limited.The diagnosis of McMurray’s test for a disease in the knee space is very specific.If McMurray’s test is positive,a disease in the knee space is highly suspected.But if McMurray’s test is negative,a disease in the knee space can not be excluded.
 
引用本文,请按以下格式著录参考文献:
中文格式:田野,白伦浩,付勤.麦氏试验对半月板损伤和膝关节间隙内疾病的诊断价值比较[J].中国骨伤,2007,20(11):736~738
英文格式:TIAN Ye,BAI Lun-hao,FU Qin.Comparison the diagnostic values of McMurray’s test between a meniscus injury and a disease in the knee space[J].zhongguo gu shang / China J Orthop Trauma ,2007,20(11):736~738
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