摘要
目的探讨X线投照体位对骨垢分离、四肢关节脱位与肋骨骨折诊断价值。方法102例骨垢分离、四肢关节脱位与肋骨骨折患者,合理展开四肢X线投照诊断,期间针对患者邻近端关节需要进行诊断,以对解剖位置进行充分观察,此外合理进行功能位摄取。观察本组骨垢分离、四肢关节脱位与肋骨骨折患者X线投照体位相关的漏诊与误诊情况。结果实施首次X线投照体位期间,表现出投照体位选择不当或者选择错误,从而导致肋骨骨折无法发现5例(4.90%);其中1例属于第1、2肋骨骨折,2例属于膈下肋骨骨折,1例属于3~9肋骨骨折,1例伴有中、大量胸腔积液现象;对于上述5例患者实施第2次X线检查,通过透视下点片将肋骨骨折检出率提高,但仍未有效检出肋骨骨折患者2例,其中1例属于第2肋骨骨折,1例属于第10~12肋骨骨折。因为X线投照体位未正确选择,所以针对患者实施首诊X线平片检查,发现漏诊或者误诊患者7例。其中属于双侧多发性肋骨骨折患者5例:因为较差投照条件导致对侧第9~12肋膈下部分无法显示患者2例,未进行对侧平片拍摄患者2例,因为多量积液掩盖患者1例;因为膈下肋骨投照条件较差或者多量积液掩盖导致无法显示的患者有2例。结论临床将X线投照体位正确选择力度加强,对于X线诊断率提高可以做出充分保证,实现患者诊断效果提升、有效预后。
Objective To discuss the value of X-ray projection position on the diagnosis of bone scaling separation,limb joint dislocation and rib fracture.Methods 102 patients with bone scaling separation,limb joint dislocation and rib fracture were reasonably diagnosed with X-ray projection of limbs.During this period,the diagnosis of patients’adjacent joints was performed,so as to fully observe the anatomical position,and reasonably take the functional position.The missed diagnosis and misdiagnosis related to the X-ray projection position of patients with bone scaling separation,limb joint dislocation and rib fracture were observed.Results In the first course of X-ray projection position,due to improper or wrong selection of projection position,5 cases(4.90%)of rib fracture were impossible to be found,wherein 1 case belonged to the first and second rib fractures,2 cases belonged to subphrenic rib fractures,1 case belonged to 3rd-9th rib fractures,and 1 case was accompanied by moderate and large pleural effusion.For the above 5 patients,the second X-ray examination was performed,and the detection rate of rib fracture was improved by taking spot image under X-ray,but 2 cases of rib fracture were not effectively detected yet.Among these 2 cases,1 case belonged to the second rib fracture and 1 case belonged to 10th-12th rib fracture.Because the X-ray projection position was not correctly selected,in the first course of X-ray plain film examination,7 patients were missed or misdiagnosed.Among the 7 cases,there were 5 cases with bilateral multiple rib fractures;there were 2 cases in which contralateral subphrenic part of the 9th-12th rib could not be displayed,because of poor projection conditions;there were 2 cases with no contralateral plain film;1 case due to the part was covered by a large amount of effusion;and there were 2 cases the image could not be displayed because of poor projection conditions of subphrenic ribs or covering up of a large amount of effusion.Conclusion Strengthening the correct selection of X-ray pro
作者
刘卫
LIU Wei(Department of Radiology,Third People’s Hospital of Jinan,Jinan 250132,China)
出处
《中国现代药物应用》
2021年第24期80-82,共3页
Chinese Journal of Modern Drug Application
关键词
X线投照体位
骨垢分离
四肢关节脱位
肋骨骨折
诊断结果
X-ray projection position
Bone scaling separation
Limb joint dislocation
Rib fracture
Diagnosis results
