CAJ | 학술논문

目的：分析91例骨密度检测结果，提出骨质疏松诊断中的一些难点，与同行商榷。方法选取2013年1月10日至2013年1月11日两天在我院行双能X线检查的患者、体检者共91人。其中男性51例，女性40例。记录91例受检者年龄、身高、体重，采用法国MEDI MINK公司生产的OSTEOCORE 3双能X线骨密度检测仪，检测患者腰椎、左髋、右髋骨密度，系统自动求出均值，以最低T值作为诊断依据，计算骨质疏松发病率并加以分析，提出诊断难点。结果通过分析认为骨质疏松诊断存在以下难点：1．骨质疏松的诊断应采用什么标准？2．双能X线骨密度检测主要检测腰椎、左髋、右髋，应采用哪个部位的检测结果？3．青少年如何诊断？4．病史与骨密度检测结果不符、高骨密度如何诊断？5．骨质疏松科普知识匮乏，患者不能主动求医，6．临床医师对骨质疏松的认知不够，不能满足患者的需要等。结论骨质疏松作为导致老年人骨折、致残、致死，严重影响老年人身心健康的常见病、多发病，越来越受到全社会的关注。骨质疏松的诊断手段亦日愈发展，双能X线骨密度检测使得骨质疏松的诊断变得准确且容易了，但骨质疏松的诊断仍存在许多难点，这些难点有的存在分岐，有的还没有研究方法和结果，改进、提高骨质疏松诊断的准确率，需要医务工作者做更多的研究，需要全社会的参与。
목적：분석91례골밀도검측결과，제출골질소송진단중적일사난점，여동행상각。방법선취2013년1월10일지2013년1월11일량천재아원행쌍능X선검사적환자、체검자공91인。기중남성51례，녀성40례。기록91례수검자년령、신고、체중，채용법국MEDI MINK공사생산적OSTEOCORE 3쌍능X선골밀도검측의，검측환자요추、좌관、우관골밀도，계통자동구출균치，이최저T치작위진단의거，계산골질소송발병솔병가이분석，제출진단난점。결과통과분석인위골질소송진단존재이하난점：1．골질소송적진단응채용십요표준？2．쌍능X선골밀도검측주요검측요추、좌관、우관，응채용나개부위적검측결과？3．청소년여하진단？4．병사여골밀도검측결과불부、고골밀도여하진단？5．골질소송과보지식궤핍，환자불능주동구의，6．림상의사대골질소송적인지불구，불능만족환자적수요등。결론골질소송작위도치노년인골절、치잔、치사，엄중영향노년인신심건강적상견병、다발병，월래월수도전사회적관주。골질소송적진단수단역일유발전，쌍능X선골밀도검측사득골질소송적진단변득준학차용역료，단골질소송적진단잉존재허다난점，저사난점유적존재분기，유적환몰유연구방법화결과，개진、제고골질소송진단적준학솔，수요의무공작자주경다적연구，수요전사회적삼여。
Objective To analyze 91 cases of bone mineral density ( BMD) measurement results, and to present and discuss the diagnostic difficulty.Methods Ninety-one osteoporosis patients and healthy people who received duel-energy X-ray absorptiometry test in our hospital from January 10th 2013 to January 11th 2013 were selected, including 51 males and 40 females.Age, height, and weight of the 91 cases were recorded.The BMD of the lumbar vertebrae, the left hip, and the right hip was measured using the Osteocore 3 duel-energy X-ray absorptiometry ( MED MINK Corporation, France) .Using the minimal T value as the diagnostic basis, the incidence of osteoporosis was calculated and analyzed.The diagnostic difficulty was presented.Results According to the result analysis, the diagnostic difficulty of osteoporosis was as following:1) What standard should be used for osteoporosis diagnosis?2) Duel-energy X-ray absorptiometry were mainly used to measure the BMD of the lumbar vertebrae, the left hip, and the right hip. From which test results of the 3 parts should be applied for the diagnosis?3) How to diagnose the juvenile osteoporosis?4) When the history was not consistent with BMD results, how to diagnose according to high BMD result?5) Patients were less initiative to see a doctor due to lack of popular science knowledge of osteoporosis.6 ) The clinicians paid less attention to osteoporosis diagnosis, which would not meet the need of the patients.Conclusion Osteoporosis is a popular disease which can lead to senile fractures, disability, and death and can seriously affect physical and mental health of the elderly.More and more attention should be paid to the osteoporosis diagnosis.With the development of the diagnostic method of osteoporosis, the diagnosis becomes easy and accuracy using duel-energy X-ray absorptiometry.However, the difficulty still exists in osteoporosis diagnosis.Among these difficulties, some are because of the different opinions, and some are caused by lack of study methods and results.Improving the diagnostic accuracy of osteoporosis needs more study and clinical work.It also needs involvement of the whole society.