| 冈上肌腱撕裂查体试验的诊断价值研究 |
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投稿时间：2021-08-16
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| 作者 | Author | 单位 | Address | E-Mail |
| 邹阿鹏 |
ZOU A-peng |
滨州医学院烟台附属医院关节外科及运动医学科, 山东 烟台 264000 |
Department of Sports Medicine and Joint Surgery, Yantai Hospital Affiliated to Binzhou Medaical University, Yantai 264000, Shandong, China |
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| 安丰敏 |
AN Feng-min |
滨州医学院烟台附属医院关节外科及运动医学科, 山东 烟台 264000 |
Department of Sports Medicine and Joint Surgery, Yantai Hospital Affiliated to Binzhou Medaical University, Yantai 264000, Shandong, China |
an2every@163.com |
| 辛运强 |
XIN Yun-qiang |
滨州医学院烟台附属医院关节外科及运动医学科, 山东 烟台 264000 |
Department of Sports Medicine and Joint Surgery, Yantai Hospital Affiliated to Binzhou Medaical University, Yantai 264000, Shandong, China |
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| 期刊信息：《中国骨伤》2022年，第35卷，第3期，第220-224页 |
| DOI：10.12200/j.issn.1003-0034.2022.03.005 |
| 基金项目: |
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中文摘要:
目的: 探讨6种常用查体试验对冈上肌腱撕裂的诊断价值，并评估这6种临床查体是否可以区分冈上肌腱部分或全层撕裂。
方法: 选择2017年6月至2020年9月因肩关节疾病行肩关节镜下手术治疗的91例患者，其中男49例，女42例；年龄31~68（50.8±11.0）岁；右侧70例，左侧21例。术前采用Hug-up试验、Jobe试验、0°位外展试验、Neer试验、Hawkins试验、落臂试验6种方式查体，查体结果与术中探查结果比较，评价查体试验诊断价值，评价指标包括灵敏度、特异性、阳性预测值、阴性预测值、准确度、阳性似然比、阴性似然比。
结果: 91例经肩关节镜术中探查共发现44例冈上肌腱全层撕裂，34例冈上肌腱部分撕裂，13例无撕裂。Hug-up试验、Jobe试验查体结果与手术探查结果有明显关联性（χ2=20.222，P=0.000；χ2=10.941，P=0.010）。Hug-up试验、Jobe试验、0°位外展试验、落臂试验、Neer试验、Hawkins试验6种查体方法灵敏度分别为0.90、0.79、0.64、0.42、0.49、0.24，特异性分别为0.61、0.69、0.54、0.38、0.31、0.77，阳性预测值分别为0.93、0.94、0.89、0.80、0.81、0.86，阴性预测值分别为0.50、0.36、0.20、0.10、0.09、0.14，准确率分别为0.86、0.78、0.63、0.42、0.46、0.32，阳性似然比分别为2.30、2.58、1.39、0.69、0.71、1.06，阴性似然比分别为0.16、0.30、0.67、1.50、1.65、0.98。
结论: Hug-up试验、Jobe试验诊断冈上肌腱撕裂可靠，Hug-up试验更具诊断价值，查体试验无法辨别冈上肌腱部分或全层撕裂。 |
| 【关键词】冈上肌 回旋套损伤 诊断 |
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| Diagnostic value of physical examination tests for supraspinatus tendon tears |
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ABSTRACT
Objective: To investigate the diagnostic value of 6 conventional physical examination tests for the diagnosis of supraspinatus tendon tears,and how well they could tell the difference between partial-and full-thickness tears.
Methods: A total of 91 patients with different shoulder symptoms who received shoulder arthroscopic procedure were enrolled in the study from June 2017 to September 2020. The intraoperative findings were compared with the results of the preoperative physical examination of 6 clinical tests,including the Hug-up test,the Jobe test,the 0°bduction test,the drop arm test,the Neer test,and the Hawkins test,to determine the sensitivity,specificity,positive and negative predictive value,accuracy,positive and negative likelihood ratio of each test.
Results: By arthroscopy,a total of 44 full-thickness tears,34 partial-thickness tears,and 13 intact supraspinatus tendons were found in all 91 cases. The Hug-up and the Jobe tests significantly correlated with the intraoperative findings. The sensitivity of the Hug-up test,the Jobe test,the 0° abduction test,the drop arm test,the Neer test,and the Hawkins test was 0.90,0.79,0.64,0.42,0.49,0.24 respectively;the specificity was 0.61,0.69,0.54,0.38,0.31,0.77;the positive predictive value was 0.93,0.94,0.89,0.80,0.81,0.86;the negative predictive value was 0.50,0.36,0.20,0.10,0.09, 0.14;the accuracy was 0.86,0.78,0.63,0.42,0.46,0.32;the positive likelihood ratio was 2.30,2.58,1.39,0.69,0.71,1.06;and the negative likelihood ratio was 0.16,0.30,0.67,1.50,1.65,0.98.
Conclusion: The Jobe test and the Hug-up test are both effective at accurately diagnosing supraspinatus tendon tears,the Hug-up test detects supraspinatus tears with a high sensitivity,and similar specificity. The tests assessed in this study are not capable of distinguish between partial-and full thickness supraspinatus tendon tears. |
| KEY WORDS Supraspinatus Rotator cuff injuries Diagnosis |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 邹阿鹏,安丰敏,辛运强.冈上肌腱撕裂查体试验的诊断价值研究[J].中国骨伤,2022,35(3):220~224 |
| 英文格式: | ZOU A-peng,AN Feng-min,XIN Yun-qiang.Diagnostic value of physical examination tests for supraspinatus tendon tears[J].zhongguo gu shang / China J Orthop Trauma ,2022,35(3):220~224 |
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