医用放大镜辅助口腔黏膜病临床视诊的价值

目的：研究医用放大镜在提高口腔黏膜病临床诊断效率中的作用及其最适合的临床使用参数。方法：选取24例斑块型口腔扁平苔藓及均质型口腔白斑病病例，以组织病理学检查结果为标准，评价经肉眼视诊和医用放大镜辅助视诊的敏感度、特异度和准确度；以问卷调查方式研究医用放大镜辅助视诊对口腔黏膜病诊断的主观有效率、使用体验并探讨其最适合的临床使用参数。结果：医用放大镜辅助视诊鉴别斑块型口腔扁平苔藓及均质型口腔白斑病的敏感度、特异度、准确度分别为94.74%、100.00%、95.83%，均高于肉眼视诊的敏感度、特异度、准确度（89.47%、80.00%、87.50%）。医生使用的主观评价认为医用放大镜辅助诊断的有效率为91.76%。口腔黏膜病临床诊治最适参数为放大倍数3.5倍，工作距离400?mm。结论：医用放大镜能够有效提高口腔黏膜病的视诊诊断效率，且具有方便、实时的特点。推荐临床使用参数为放大倍数3.5倍，工作距离400?mm。

Application of medical magnifying loupes in diagnosis of oral mucosal diseases

Objective: To evaluate the application of medical magnifying loupes in diagnosis of oral mucosal diseases. Methods: Twenty-four patients with plaque-type oral lichen planus or homogeneous oral leukoplakia were inspected by naked eyes or assistance with magnifying loupes. Histopathological results were used as the gold standard to evaluate the sensitivity, specificity and accuracy of the two methods in clinical diagnosis. Questionnaires were used to evaluate the subjective effect of magnifying loupes on the diagnosis efficiency of oral mucosal diseases and to explore the most suitable parameters for application. Results:The sensitivity, specificity and accuracy of medical magnifying loupes for the identification of plaque-type oral lichen planus and homogeneous oral leukoplakia were 94.74%, 100.00% and 95.83%, respectively, which were significantly higher than those of naked eye inspection (89.47%, 80.00% and 87.50%). The effective rate of magnifying loupes assisted diagnosis was 91.76% according to physicians’ subjective evaluation. The most suitable parameters were 3.5 times magnification and 400?mm working distance. Conclusion: The medical magnifying loupes can effectively improve the efficiency of the inspection and diagnosis of oral mucosal diseases, and have the characteristics of convenience and real-time. The recommended clinical parameters are 3.5 times magnification and 400?mm working distance.