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膝部關節鏡之研究第二報:關節鏡診斷之正確率

Arthroscopy of the Knee Part II: Diagnostic Accuracy

摘要


台北市立中興醫院發展關節鏡來,5年中,作者總共為168位患者施行開膝手術,這168位患者手術前皆曾接受關節鏡檢查。168位中,78位接受半月軟骨切除術,41位接受Pridie手術,22位接受單純性的滑膜切除術,7位韌帶接補術,7位人工關節置換術,另有13位是採用2種以上的混合手術方式。 除了45例的「問題膝」(problem knee)沒有臨床診斷外,其餘的患者在手術前皆已寫下「臨床診斷」及「關節鏡之診斷」。作者再根據開膝所見來評估「臨床診斷」與「關節鏡診斷」的正確率。結果發現臨床診斷的正確率為69.05%,而關節鏡之診斷卻高達97.62%以上,即168例中,164例關節鏡之所見與開膝所見完全相同,另3例為「不完全診斷」,1例為「不正確診斷」。 臨床診斷或關節鏡診斷的正確率與檢查者的臨床經驗和關節鏡之檢查技術與判讀有極密切的關係。

關鍵字

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並列摘要


The authors evaluated the diagnostic valus of arthroscopy based on 168 knee arthrotomies performed in the past 5 years. There were 78 meniscectomies, 41 Pridie operations, 22 simple synovcetomies, 7 ligament repairs, 7 total knee arthroplasties, and 13 operations of combined procedures. Among 168 arthrotomies, preoperative arthroscopy was correct in 164 cases, incompletely correct in 3 and incorrect in 1. The diagnostic accuracy of arthroscopy was 97.62%, but clinical diagnostic rate was only 69.05%. Either clinical or arthroscopic diagnostic accuracy was effected by clinical experience and technique of arthroscopy.

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