锁骨轴位改良投照技术临床应用.docVIP

锁骨轴位改良投照技术临床应用 　 作者：郑卫东，庄儒耀，陈显恩，郑邦豪 【关键词】 锁骨 　　［关键词］ 锁骨；骨折；X线 　　［摘 要］ 目的：探讨锁骨骨折轴位改良投照技术的临床应用。方法：采用仰卧前后位，将球管向头侧倾斜30°角~40°角，对准患侧锁骨中点进行投照点片。结果：15例锁骨骨折伤患，采用常规后前位投照，仅3例明显显示骨折端前后移位和/或向后成角X线征；1例小儿未被发现骨折；其余11例骨折伤患显示骨折端对位对线良好。而采用改良轴位投照，原诊对位对线良好的11例患者，7例出现明显前后移位和/或成角的X线征；1例原未见骨折的小儿伤患，显示青枝骨折X线征。结论：锁骨骨折投照中，常规后前位投照不能全面反映骨折情况，应用锁骨轴位改良投照技术，能够较明确反映锁骨骨折骨折线对位对线情况，提高锁骨骨折诊断价值。 　　Clinical Application of Modified Clavicle Axial Projection 　　　Abstract：Objective To study the clinical application of modified clavicle axial projection in the diagnosis of clavicle fractures.Methods The supination AP position was employed,the Xray tube was put headward 30~40 angles,the midpoint of the affected lateral clavicle was aimed at and projected.Rasults Of 15 cases of clavicle fractures,while projected with routine PA position,only 3 cases of fractures could be demonstrated with anteriorposterior shift and (or)backwards angulation.1 case of child was reported normal.The other 11 cases were demonstrated fractures with no shift and angulation.But after the modified clavicle axial projection was adopted,among the 11 cases which were reported fractures with no shift and angulation earlier,7 cases appeared distinct fractures with anterior posterior shift and (or)backwards angulation.The case of child,which was reported normal earlier,now was demonstrated greenstick fracture.Conclusion The routine PA position projection can not reflect the conditions of clavicle fractures completely.So the modified clavicle axial projection should be adopted to improve the value of Xray diagnosis in clavicle fractures. 　　Key words：Clavicle；Fractures；Xray 对我院自2001年9月至2004年12月采用常规锁骨后前位及锁骨轴位改良投照技术且明确诊断为锁骨骨折的15例病例进行回顾性分析，现将其投照体会报告如下。 　　1 材料与方法 　　1.1 一般资料 　　15例锁骨骨折伤患，其中21岁~40岁7例，40岁~60岁6例，1岁~5岁2例，平均年龄为38岁。男9例，女6例。 　　1.2 方法 　　15例伤患先在菲利普Duo Diagnost 800 mA数字X光机下对锁骨进行透视，初步了解锁骨骨折情况，然后常规摄取锁骨后前位片，对可疑骨折或需了解骨折对位对线情况者再采用锁骨轴位改良投照技术进行投照点片。锁骨轴位改良投照技术体位设计：采用仰卧前后位，手掌向上，双上臂自然放置于身旁，头转向对侧，将球管向头侧倾斜30°~40°角［1］,透视下定位将中心线对准锁骨中点进行数字化采集或屏片系统点片。 　　2