DR和CT诊断在脊柱爆裂型骨折中的应用价值

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摘要目的探讨数字X线摄影（DR）和电子计算机断层扫描（CT）诊断在脊柱爆裂型骨折中的应用价值。方法选取2018年1月～2019年12月赣州市南康区第二人民医院收治的60例疑似脊柱爆裂型骨折患者作为研究对象，根据手术结果将其分为脊柱爆裂型骨折患者（n=14）和非脊柱爆裂型骨折患者（n=46），全部患者术前均行DR、CT检查，比较两种不同检查方法的检查时长、检查费用、符合率。以手术结果为参照，分析脊柱爆裂型骨折诊断结果及效能。结果 CT检查时间为（8.47±1.49）min，长于DR的（2.36±0.85）min，差异有统计学意义（P＜0.05）；CT检查费用为（645.32±51.94）元，高于DR的（110.87±23.15）元，差异有统计学意义（P＜0.05）；CT诊断脊柱爆裂型骨折的符合率（92.86%）高于DR（57.14%），差异有统计学意义（P＜0.05）；CT诊断脊柱爆裂型骨折患者骨碎片、椎体移位、椎管狭窄、椎体骨折线的符合率分别为78.57%、83.33%、84.62%、85.71%，高于DR诊断脊柱爆裂型骨折患者的35.71%、41.67%、30.77%、35.71%，差异有统计学意义（P＜0.05）；CT诊断脊柱爆裂型骨折的敏感度、特异度、准确率为85.71%、97.83%、95.00%，高于DR诊断的35.71%、78.26%、68.33%，差异有统计学意义（P＜0.05）；CT诊断脊柱爆裂型骨折的漏诊率、误诊率为14.29%、2.17%，低于DR诊断的64.29%和21.74%，差异有统计学意义（P＜0.05）。结论与DR 检查方式相比，在脊柱爆裂型骨折诊断中应用CT检查能够有效明确患者伤椎状态，提高脊柱爆裂型骨折的诊断效能，减少漏诊、误诊，但检查时间较长，检查费用较高。

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	付连山1 蓝希灵2 周裕雨1

关键词 ： , font-size: 16px, text-align: justify, 数字X线摄影')" href="#">">数字X线摄影, 电子计算机断层扫描, 脊柱爆裂型骨折, 诊断

Abstract： Objective To explore the application value of digital radiography (DR) and computed tomography (CT) in the diagnosis of spinal blowout fractures.Methods A total of 60 patients suspected with spinal blowout fracture from January 2018 to December 2019 in the Second People′s Hospital of Nankang District of Ganzhou City were selected as the research objects.According to the operation results，they were divided into the spinal blowout fracture patients (n=14) and the non-spinal blowout fracture patients (n=46).All patients underwent DR and CT examination before operation.The inspection time，examination cost and the coincidence rate of two different inspection methods were compared.The operation results were used as reference，the spinal blowout fracture diagnostic results and efficacy was analyzed.Results CT examination time was (8.47±1.49) min，which was longer than that of DR examination time ([2.36±0.85]min)，the difference was statistically significant (P＜0.05).CT examination cost was (645.32±51.94) yuan，which was higher than that of DR examination cost ([110.87±23.15]yuan)，the difference was statistically significant (P＜0.05).The coincidence rate of CT diagnosis of spinal blowout fracture was 92.86%，which was higher than that of DR (57.14%)，the difference was statistically significant (P＜0.05).The coincidence rates of bone fragments，vertebral displacement，spinal stenosis and vertebral fracture line of CT diagnosis were 78.57%，83.33%，84.62% and 85.71%，respectively，which were higher than those of DR diagnosis of spinal burst fractures (35.71%，41.67%，30.77% and 35.71%，respectively)，and the differences were statistically significant (P＜0.05).The sensitivity，specificity and accuracy of CT in the diagnosis of spinal burst fractures were 85.71%，97.83% and 95.00%，which were higher than 35.71%，78.26% and 68.33% of DR diagnosis，and the differences were statistically significant (P＜0.05).The missed diagnosis rate and misdiagnosis rate of CT were 14.29% and 2.17%，which were lower than 64.29% and 21.74% of DR diagnosis，and the differences were statistically significant (P＜0.05).Conclusion Compared with DR examination，CT examination in the diagnosis of spinal blowout fractures can effectively clarify the status of patients with vertebral injuries，improve the diagnostic efficiency of spinal burst fractures，reduce missed diagnosis and misdiagnosis，but the inspection time is longer and the examination cost is higher.

Key words： font-size: 16px Digital radiography;Computed tomography;Spinal blowout fractures;Diagnosis')" href="#">text-align: justify;">Digital radiography;Computed tomography;Spinal blowout fractures;Diagnosis

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基金资助: 江西省赣州市指导性科技计划项目（GZ2019ZSF348）

引用本文:

付连山1 蓝希灵2 周裕雨1. DR和CT诊断在脊柱爆裂型骨折中的应用价值[J]. 中国当代医药, 2020, 27(33): 154-157.
FU Lian-shan1 LAN Xi-ling2 ZHOU Yu-yu1. Application value of DR and CT in the diagnosis of spinal blowout fractures. 中国当代医药, 2020, 27(33): 154-157.

链接本文:

https://www.dangdaiyiyao.com/CN/ 或 https://www.dangdaiyiyao.com/CN/Y2020/V27/I33/154

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