X线平片与CT后处理技术在多发性肋骨骨折固定术中的应用价值研究

Application of X-ray Plain Film and CT Post-processing Technique in Multiple Rib Fracture Fixation

目的旨在探讨X线平片与CT后处理技术在多发性肋骨骨折固定术中的应用价值。方法选取我院2017年1月到2018年4月收治的100例多发性肋骨骨折患者,比较X线平片、CT后处理技术对多发性肋骨骨折的诊断灵敏度、特异度及检出率,分析X线平片、CT后处理技术在多发性肋骨骨折术前诊断、术后复查中的价值。结果 X线平片对多发性肋骨骨折的诊断灵敏度、特异度及检出率分别为73.16%、68.83%、85.28%,CT后处理技术则分别为94.80%、90.90%、98.70%,CT后处理技术对多发性肋骨骨折的诊断灵敏度、特异度及检出率均明显高于X线平片(P<0.001);完全性骨折、不完全性骨折X线表现各异,对于确诊合并胸腔积液者行引流管处理,三维重建中,可清晰见患者肋骨多发肋骨骨折部位、数量、形态和移位方向,根据患者三维重建图像进行了肋骨骨折固定术治疗,术后1-7天内复查CT平扫,肋骨多发骨折内固定取出术后复查胸部X线平片。结论 CT后处理技术对多发性肋骨骨折诊断、检出效能均优于X线平片,临床可根据图像资料制定相关手术方案,固定取出术后复查采用X线平片更经济、便捷。

Objective To evaluate the value of X-ray plain film and post-processing technique of CT in the fixation of multiple rib fractures. Methods 100 patients with multiple rib fractures admitted to our hospital from January 2017 to April 2018 were selected to compare the sensitivity, specificity and detection rate of X-ray plain film and CT post-processing technology in the diagnosis of multiple rib fractures. The value of X-ray plain film and CT post-processing technology in the preoperative diagnosis and post-operative re-examination of multiple rib fractures was analyzed. Results The diagnostic sensitivity, specificity and detection rate of X-ray plain film for multiple rib fractures were 73.16%, 68.83% and 85.28%, respectively. The post-processing techniques of CT were 94.80%, 90.90% and 98.70%, respectively. The diagnostic sensitivity,specificity and detection rate of post-processing techniques of CT for multiple rib fractures were significantly higher than those of X-ray plain film(P<0.001). Complete fracture and incomplete fracture have different X-ray manifestations. The patients with pleural effusion were treated with drainage tube. In three-dimensional reconstruction,the location, number, shape and displacement direction of multiple rib fractures could be clearly seen. Fixation of rib fracture was performed according to the three-dimensional reconstruction image of the patient. CT plain scan was performed within 1 to 7 days after operation, and the chest X-ray films were taken after internal fixation of multiple rib fractures. Conclusion CT post-processing technology is superior to X-ray plain film in the diagnosis and detection of multiple rib fractures. Clinically, relevant surgical procedures can be formulated according to the image data, and X-ray plain film is more economical and convenient for re-examination after fixation and removal.