超声引导与X线定位在四肢异物取出术中的对比研究  

A clinical comparative study of ultrasound and X-ray localization in removal of foreign body in extremities

作　　者：许文波 胡炜 肖秋金 杨洋[1] 李浩[1] 双峰[1] XU Wenbo;HU Wei;XIAO Qiujin;YANG Yang;LI Hao;SHUANG Feng(Department of Orthopaedics,The 908th Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army,Nanchang 330002,China)

机构地区：[1]中国人民解放军联勤保障部队第九〇八医院骨科,南昌330002

出　　处：《中华骨与关节外科杂志》2022年第6期451-454,共4页Chinese Journal of Bone and Joint Surgery

基　　金：江西省自然科学基金(2017BAB205032)

摘　　要：目的:对比分析超声引导与X线定位在骨科四肢异物存留取出术中的应用体会及应用价值,为手术方案的选择提供一定的临床依据。方法:前瞻性纳入2017年6月至2019年6月收治的X线检查下显影的四肢异物存留患者50例,按随机数字表法分为:超声组25例,术前预先进行超声定位,术中采用超声引导进行异物取出术;X线组25例,术前进行X线定位,术中采用X线透视定位进行异物取出术。记录两组患者的手术时间、切口长度、术中失血量、一次异物取出成功率、手术并发症及随访3个月的愈合情况,并进行对比分析。结果:与X线组比较,超声组的手术时间、切口长度和术中失血量均明显降低(P均<0.05),一次异物取出成功率明显提高(P<0.05)。所有患者的体内异物均完整取出,无异物残留,无血管、肌腱、神经或术后肢体功能障碍等并发症发生。50例全部获得随访,随访时间3~6个月,与X线组比较,超声组的伤口愈合时间更短,伤口感染例数更少(P均<0.05)。结论:对于病史明确的四肢异物存留患者,超声引导在异物取出方面相较X线定位具有明显优势,建议临床推广使用。Objective:To compare the application value of ultrasound guidance and X-ray positioning in removal of foreign body in extremities,so as to provide a certain basis for clinical selection of surgical plans.Methods:Totally 50 patients with foreign bodies in the extremities manifested by X-ray examination,who were admitted in hospital from June 2017 to June 2019,were enrolled in this prospective study.All patients were divided into two groups as ultrasound group undergoing preoperative ultrasound localization and intraoperative ultrasound guidance and X-ray group using X-ray for localization of foreign body with 25 patients of each according to random table.The operation time,incision length,intraoperative blood loss,success rate of one-time foreign body removal,complications and prognosis at 3-month follow-up were recorded and compared between the two groups.Results:Compared with X-ray group,the operation time,incision length and intraoperative blood loss were significantly reduced(all P<0.05),and the success rate of one-time foreign body removal significantly increased(P<0.05)in ultrasound group.All patients had foreign bodies completely removed and no vascular,tendon or nervous complications as well as postoperative limb dysfunction occurred.All patients were followed up for 3-6months.Compared with X-ray group,patients in ultrasound group had a shorter wound healing time and fewer wound infections(all P<0.05).Conclusions:For patients with extremity foreign bodies confirmed by clear medical history,ultrasound guidance is preferred because of the obvious advantages in removal of foreign bodies to X-ray location,which is recommended for clinical promotion.

关 键 词：超声检查 X线检查 异物 四肢 

分 类 号：R445.1[医药卫生—影像医学与核医学] R658[医药卫生—诊断学]