桡骨远端关节内骨折伴腕关节不稳定放射诊断的效果研究

The Effect of Radiological Diagnosis of Intra-articular Fracture of the Distal Humerus and Wrist Joint Instability

目的观察放射诊断法在桡骨远端关节内骨折伴腕关节不稳定中的应用价值。方法选择2016年8月—2017年12月该院接诊的桡骨远端关节内骨折伴腕关节不稳定病患120例,将之采用随机数表法分成A和B两组(n=60)。A组实行CT联合X线诊断,B组实行X线诊断。综合分析两组的诊断治疗结果,并对1.5个月基本痊愈率等指标作出比较。结果 A组CT诊断关节面分离、桡骨缩短、背侧关节面塌缩、干骺端骨折以及关节面骨块>3块的准确率依次是81.67%、51.57%、88.33%、56.56%、65.0%,明显比X线诊断的63.33%、35.0%、66.67%、40.0%、50.0%高,组内比较差异有统计学意义(χ~2=5.057 5,5.658 3,8.076 5,5.491 2,4.603 6,P<0.05)。A组的1.5个月基本痊愈率为91.67%、2.5个月完全痊愈率为95.0%,明显比B组的68.33%、81.67%高,组间差异有统计学意义(χ~2=17.0236,8.6221,P<0.05)。结论若患者的经济条件允许,临床医师可建议其采取CT放射诊断疗法,以显著提高其各观察指标的诊断准确率,促进骨折创口愈合,提高预后效果。

Objective This paper tries to observe the diagnostic value of radiological diagnosis in the intra-articular fracture of the distal humerus with wrist joint instability. Methods A total of 120 patients with intra-articular fractures of the distal humerus and wrist instability received at the hospital from August 2016 to December 2017 were selected and divided into group A and B（n=60） using a random number table method. In group A, CT and X-ray diagnosis were performed, and in group B, X-ray diagnosis was performed. Comprehensive analysis of the two groups of diagnosis and treatment results, and to compare the basic recovery rate of 1.5 months and other indicators. Results The accuracy of CT diagnosis of articular surface dissection, tibial shortening, posterior articular surface collapse, metaphyseal fracture and articular surface bone mass 3 were 81.67%, 51.57%, 88.33%, 56.56%, 65.0%, significantly higher than the63.33%, 35.0%, 66.67%, 40.0%, 50.0% of the X-ray diagnosis, the difference within the group was significant（χ^2=5.057 5,5.658 3, 8.076 5, 5.491 2, 4.603 6, P〈0.05）. In group A, the basic cure rate was 91.67% at 1.5 months and95.0% at 2.5 months, which was significantly higher than that of group B at 68.33% and 81.67%. The differences between groups were significant（χ^2=17.023 6, 8.622 1, P〈0.05）. Conclusion If the patient＇s economic conditions permit, clinicians can suggest CT radiodiagnostic therapy to significantly improve the diagnostic accuracy of each observation index, promote fracture healing, and improve the prognosis.