应用超声估测膝关节积液量方法的初步建立

摘要

Objective To explore a more simple and easy-to-operate method for estimating knee joint effusion,by application of ultrasound to detect patients with knee joint effusion according to the effusion depth gauge effusion quantity.Methods A total of 54 cases of patients with knee joint swelling were enrolled in this study.Application of ultrasound to exam 108 knee joints,81 of the knee joints have effusion.Firstly,61 of the knee joints with effusion were selected for semi-quantitative ultrasonic classification.Secondly,the center of suprapatellar,medial and lateral of longitudinal section for measuring surface were selected,effusion depth were measured at fully non-pressurized condition.Finally punctured pumping effusion was guided by ultrasound to record each joint effusion quantity.According to the distribution of effusion,61 knee joints were divided into three groups.Results There was a significant difference between suprapatellar effusion depth and the medial aspect by ultrasound(P＜0.05).The consistent grading has a statistically significant between ultrasonic semi-quantitative classification and ultrasound guided puncture group,but the degree of consistency was not ideal.By ultrasonic measurement,when effusion volume was less than 20 mL,average depth of effusion was(4.693±1.831) mm,when effusion volume was at the range of 20-40 mL,average depth of effusion was(8.085±1.933) mm,when effusion volume was more than 40 mL,average depth of effusion was(11.027±1.831)mm.Conclusion It is a simple and convenient method to measure the depth of knee joint effusion by ultrasound,which can provide a clinical reference value for estimating the effusion volume.%目的 应用超声对患者膝关节积液进行探测,根据积液深度估测积液量,探索一种更简单、易操作的膝关节积液估测方法.方法 选取54例膝关节肿痛患者的108个膝关节进行超声检查,81个膝关节有积液,选取61个有积液的膝关节首先进行超声半定量分级,其次分别以髌上正中、内侧、外侧3个纵切面为测量面,完全不加压状态下测量3个纵切面的积液深度,最后在超声引导下进行关节穿刺抽液,记录每个关节的积液量,根据积液量分布情况将61个膝关节分为3组.结果 超声测量髌上正中积液深度与内侧切面积液深度差异有统计学意义(P＜0.05).超声半定量分级与超声引导下穿刺抽液分组2种分级方法一致性差异有统计学意义,但一致性较差(Kappa=0.355＜0.4).根据积液量计算积液平均深度,积液量＜20 mL组积液平均深度为(4.693±1.831) mm,积液量20～40 mL组积液平均深度为(8.085±1.933) mm,积液量＞40 mL组积液平均深度(11.027±1.831) mm.结论 通过超声测量膝关节积液深度简便易行,对积液量估测可为临床提供一定的参考价值.