放射科肋骨骨折漏诊原因研究及防范措施.doc

放射科肋骨骨折漏诊原因研究及防范措施[摘要] 目的：探讨放射科肋骨骨折漏诊的原因及其防范措施，以降低肋骨骨折的漏诊率。方法：回顾2007年8月~2009年5月本院收治的肋骨骨折放射科首诊漏诊患者25例，分析其漏诊原因。结果：25例患者中16例（64%）因单一体位、体位选择不当或受限所致；6例（24%）因摄片条件差异及其他影像遮盖所致；3例（12%）因放射科医师读片不仔细、马虎等情况所致。结论：采取多体位摄片、选择合适的摄片条件、放射科医师结合病史仔细阅片以及及时复查，才能最大限度地减少肋骨骨折的漏诊。 [关键词] 肋骨骨折；X线检查；漏诊率；骨折 [中图分类号] R683.1 [文献标识码] C[文章编号] 1674-4721（2011）07（b）-094-02 Causes of missed diagnosis and preventive measures of rib fracture in radiology MA Jun Department of Radiology, Lishui Hospital of Nanhai, Foshan City, Guangdong Province, Foshan 528244, China [Abstract] Objective: To investigate the causes of missed diagnosis and preventive measures of rib fracture in radiology, in order to reduce rate of missed diagnosis about rib fracture. Methods: Analyzed the causes of 25 patients of rib fractureswhich were missed diagnosis by radiology in first diagnosed from August 2007 to May 2009 in our hospital. Results: In 25 patients, 16 patients (64%) were missed diagnosis due to Single position, improper selection or restricted position; 6 cases (24%) were missed diagnosis radiography conditions vary and covered by other imaging; 3 cases (12%) were missed diagnosis due to physician reading X-ray film were not careful, careless, etc.. Conclusion: Take much postures radiography, choose appropriate radiography conditions, radiologists combining with the history carefully read a slice and timely review, in order to maximize missed diagnosis of rib fracture reduction. [Key words] Rib fractures; X-ray; Rate of missed diagnosis; Fractures 肋骨骨折是常见的胸部损伤，亦是骨科常见病，且近年来其发病率有逐年增高的趋势。因此，及早的诊断和及时的治疗，对于肋骨骨折患者的治疗及预后是十分重要的。胸部X线检查是放射科的主要检查项目之一，同时也是临床上对于肋骨骨折诊断的有效手段。但是，因肋骨骨折的解剖特点及其他主、客观因素，胸部X线检查对肋骨骨折的诊断也常常出现漏诊或误诊。为探寻胸部X线检查诊断肋骨骨折漏诊的原因，进而寻求防范措施，现回顾性分析2007年8月~2009年5月本院收治的肋骨骨折放射科首诊漏诊病例25例，报道如下： 1 资料与方法 1.1 一般资料 研究对象为2007年8月~2009年5月本院收治的肋骨骨折漏诊病例25例。其中，男17例，女8例；年龄22～59岁，平均39岁。受伤原因车祸12例，打架8例，坠落伤5例。临床表现主要包括局部压痛，伴胸闷、气短等症状，少数患者存在昏迷及神志不清。初次胸部X线检查时间为外伤后30 min~2 d。该25例患者分别行胸部站立正位摄片14例，仰卧前后位摄片9例，站立位加右侧位摄片2例，均