【摘要】 目的系统评价关节液和组织培养对关节置换术后感染的诊断价值及临床应用前景。方法计算机检索Cochrane图书馆、Medline、Pubmed、中国生物医学文献数据库(CBM)、中文科技期刊全文数据库[维普(VIP)]等数据库,检索年限均从建库至2013年12月,收集关节液和组织培养对关节置换后感染的诊断试验,手工检索相关会议论文集、学位论文汇编等。根据Cochrane系统评价方法筛选研究并提取数据,采用Meta‐DiSc1.4软件进行Meta分析。结果 5篇文献符合纳入标准纳入本系统评价,总病例数748例。对临床诊断关节置换后感染有指导作用的组织培养总加权灵敏度和特异度分别为85.1%和96.9%;关节液培养的总加权灵敏度和特异度分别为77.4%和96.8%,合并数据中组织培养的敏感度和特异度存在异质性。组织培养在髋膝关节置换术后假体周围感染诊断的灵敏度显著优于关节液穿刺方法,两者比较,差异均有统计学意义(P<0.05),两者在阴性似然比及诊断效能比值比没有显著差异性(P>0.05)。结论组织培养在在对关节置换术后感染诊断的敏感度上明显优于关节液培养。更多还原

【Abstract】 Objective To systematically assess the value of the joint aspiration and the tissue biopsy in microorganism cultures used to diagnose infection after the arthroplasty surgery. Methods The databases of Cochrane library,medline,pubmed,CBM,and VIP were searched by the computer for the reports of the diagnosis biopsy of the postarthroplastic infection. The pooled summary estimates for sensitivity,specificity,positive likelihood ratio,negative likelihood ratio and diagnostic odds ratio( OR) were compared for the preoperative aspiration and the tissue biopsy cultures. Results Five articles met the inclusion cretieria. The total cohort included 748 patients. The pooled estimate of sensitivity and specificity of tissue biopsy were 85. 1% and 96. 9%,respectively. The pooled estimate of sensitivity and specificity of joint aspiration were 77. 4% and 96. 8%,respectively. Although there was no difference in specificity or diagnostic OR,the sensitivity of the tissue biopsy culture was significantly higher than that of the joint aspiration culture( P < 0. 05). Conclusion Tissue biopsy is much better than joint aspiration in the sensitivity of microorganism cultures for diagnosing the infection after the arthroplasty surgery.更多还原