肋骨骨折漏诊原因分析及避免漏诊的措施  

The analysis of the missed diagnosis in costal fracture and strategy further consultation

作　　者：杨汉卿[1] 邹一砖[1] 吴明灿[1] 

机构地区：[1]浙江省余姚市人民医院放射科,浙江余姚315400

出　　处：《医学影像学杂志》2006年第5期492-494,共3页Journal of Medical Imaging

摘　　要：目的:探讨肋骨骨折漏诊的原因及应对措施。方法:对40例96根肋骨骨折病人的一系列检查方法(包括胸部正位片、受伤处肋骨斜位片、受伤处肋骨透视下点片及3周后的肋骨点片)进行分析。结果:以外伤后的一系列检查,加上3周后的肋骨透视下点片新发现的骨折数为最后结果,回顾性对40例96根肋骨骨折病人的一系列片子进行读片,其中胸部正位片正确诊断56根肋骨骨折,正确诊断率58.1%;胸部正位片加患侧肋骨斜位片正确诊断87根肋骨骨折,正确诊断率90.4%;胸部正位片加肋骨透视下点片正确诊断91根肋骨骨折,正确诊断率94.7%;胸部正斜位片加肋骨透视下点片检查正确诊断93根肋骨骨折,正确诊断率96.9%。结论:单一胸部正位片,不宜用于诊断肋骨骨折,肋骨骨折的诊断一定要多体位摄片的组合,不同时间摄片的组合,加上认真负责的摄片及逐根肋骨的仔细诊断,才能最大限度的减少肋骨骨折的漏诊。Objective：To discuss the causes of misdiagnosis in costal fracture and get relative strategey. Methods：To analyze 40 cases of 96 costal fractures undergone a series of examination. Results： The final diagnosis were determined by the patients undergone reexamination after being wounded 3 weeks. With retrospective interpretation, the missed diagnosis rate of postereanterior view of chest is 42%, the missed diagnosis rate of postereanterior view of chest and oblique view of rib is 9%, themissed diagnosis rate of posternanterior view of chest and spot films in fluoroscopy is 4%. Conclusion：A single posteroanterior view of chest should not being used to make diagnosis of costal fraeture, postereanterior view of chest and oblique view of rib must be regular examination, posteroanterior view of chest and spot films in fluoroscopy, also with spot films after 3 weeks is the best mode of examination, which reduce the missed diagnosis in costal fracture with highest possibility.

关 键 词：肋骨骨折 X线诊断 

分 类 号：R683.1[医药卫生—骨科学] R814[医药卫生—外科学]