三种下蹲试验对半月板损伤的诊断意义

Three Squat Down Test in the Diagnosis of Meniscus Tear

目的 检查我们设计的膝关节下蹲试验对半月板损伤诊断的准确性。方法 运用前瞻性对比研究方法，研究2001年6月至2005年8月我院收治的半月板损伤患者218例，其中男性147例，女性71例，平均年龄27．3岁（15～49岁）。分别进行三种下蹲试验（小腿中立、内旋、外旋并下蹲），依膝关节的疼痛部位来判断半月板损伤部位，并与麦氏征和核磁共振影像和关节镜下所见为对照。结果 所有内侧半月板损伤患者，下蹲试验阳性率97．3％。与核磁共振的符合率为94．2％，与麦氏征的符合率为93．o％，与关节镜的诊断符合率为95．7％。其中内旋下蹲试验对内外侧半月板损伤的诊断准确率分别为93．1％和91．2％。外旋下蹲试验对内外侧半月板损伤的诊断准确率分别为86．6％和90．8％。中立下蹲试验对内外侧半月板损伤的诊断准确率为78．6％和69．4％，但对半月板后角的诊断准确率为88．6％。总体假阳性率2．7％，假阴性率1．8％。结论 三种下蹲试验对半月板损伤的诊断准确率较高，与麦氏征和核磁共振的诊断符合率高，虽然准确率低于关节镜检查，但是简便、无创、经济和无并发症。

Objective ： To study the accuracy of ＂three squat downs＂ test, which is designed by myself, in the diagnosis of the knee meniscus tear. Methods From Jun. 2001 to Aug. 2005, 218 eases of the meniscus tear were checked-up with ＂three squat down＂ test （ie, squat down while the tibial in internal, external and 0 rotaion position separately, designed by myself）, Mcmurray test, MRI and arthroscope comparatively. Results The ＂three squat down＂test is positive in all of the meniscus tear eases. The consistency with MRI, McMurray test and arthroscope is 94. 2%, 93.0% and 95.7% seperatively. The false positive rate is 2. 7% and the false negative rate is 0. 8%. The internal rotation squat down is a little sensitive than the external rotation squat down, while the no-rotation squat down is a little more sensitive to the pos＇terior horn tear of memscus than the others. Conclusion The ＂squat dwon＂ test is sensitive to the knee meniscus tear, and is： comparable with the Mcmurraytest, MRI and arthroscope examination. It is a fast, simple, reliable, reproducible and money saving test for diagnose of meniscus tear.