高频超声在急诊肋骨及肋软骨骨折中的临床应用

Clinical application of high-frequency ultrasound in the diagnosis of emergency rib and costal cartilage fractures

目的:研究高频超声在急诊肋骨与肋软骨骨折中的临床应用,为临床应用提供数据基础。方法:回顾性分析中南大学湘雅三医院就诊的90例肋骨或肋软骨骨折患者,对比高频超声与X线肋骨的肋软骨骨折、不同损伤肋骨骨折、不同错位幅度肋骨骨折的检出率,分析两者的优缺点,总结高频超声在急诊肋骨及肋软骨骨折中的诊断价值和优势。结果:高频超声的肋骨骨折、肋软骨骨折的检出率高于X线检查,差异有统计学意义(P<0.05);在直接暴力损伤中两者肋骨骨折的检出率比较无统计学意义(P>0.05),在间接暴力损伤中两者肋骨骨折的检出率高频超声优于X线检查,差异有统计学意义(P<0.05);在骨折断端错位小于0.5 mm及0.5~2.0 mm时高频超声检出率优于X线检查,差异有统计学意义(P<0.05),在骨折断端错位大于2.0 mm时,X线检查检出率与高频超声检查比较无统计学意义(P>0.05)。结论:高频超声适用于急诊胸外伤受力较小、骨折错位较轻的肋骨骨折及肋软骨骨折的早期确诊,检出率高,价格便宜,值得临床广泛应用。

Objective To study the application of high-frequency ultrasound in the diagnosis of emergency rib and costal cartilage fractures,and provide the data basis for its clinical application.Methods Ninety cases of rib or costal cartilage fractures in the Third Xiangya Hospital of Central South University were retrospectively analyzed.High-frequency ultrasound and X-ray examination were used to detect the rib or costal cartilage fractures with different injuries and different degrees of bone displacement.The detection rates of high-frequency ultrasound and X-ray examination were compared and the pros and cons of the two methods were analyzed for summarizing the diagnostic values and advantages of high-frequency ultrasound in the diagnosis of the fractures of costal cartilage and emergency rib.Results The detection rate of rib and costal cartilage fractures with high-frequency ultrasound was significantly higher than that with X-ray examination,with statistical significance（P〈0.05）.The detection rates of two methods for detecting fractures in direct violent injury had no statistically significant differences（P〈0.05）,while the detection rate of high-frequency ultrasound for detecting fractures in the indirect violence injury was higher than that of X-ray examination（P〈0.05）.When the fracture end displacement was less than 0.5 mm or between 0.5 and 2.0 mm,the detection rate of high-frequency ultrasound was superior to that of X-ray examination,with statistical differences（P〈0.05）.When the fracture end displacement was larger than 2.0 mm,the differences in the detection rate between X-ray examination and high-frequency ultrasound didn＇t showed statistically significance（P〈0.05）.Conclusion High-frequency ultrasound is suitable for the early diagnosis of the fractures of rib and costal cartilage with less stressed emergency chest trauma and slight degree of bone displacement.High-frequency ultrasound is worthy of clinical application due to its higher detection rate and lower cost.