X线透视对判断骶髂螺钉位置的实验研究  

The empirical study on the fluoroscopic imaging -guided technology in judging the position of percutaneous sacroiliac screws

作　　者：段永刚[1] 彭阿钦[2] 丁英奇[1] 

机构地区：[1]河北北方学院附属第二医院骨外科,河北省张家口市宣化区075100 [2]河北医科大学第三医院创伤急救中心

出　　处：《河北医药》2010年第15期1997-1998,共2页Hebei Medical Journal

摘　　要：目的探讨X线透视对骶髂螺钉位置判断的准确性。方法通过在成人防腐尸体骶髂关节处模拟骶髂螺钉操作打入2.5mm克氏针,用C型臂X线透视机以不同投射位置判断每枚克氏针的位置,计算每个位置下克氏针判读准确率。结果共收获成功数据107次。其中置入骶1椎体、从骶1前缘穿出、进入骶1孔或进入骶1椎管分别为38次、25次、24次和20次,第一组判读准确次数分别为35次、23次、23次、18次,准确率分别为92.1%、92.0%、95.8%和90.0%,第二组判读准确次数分别为36次、23次、22次、19次,准确率分别为94.7%、92.0%、91.7%、95.0%。计算Kappa值=0.7861,说明本次观察结果的可靠性较高。结论通过实验证实在骨盆骨折手术中X线透视对确定骶髂螺钉位置是一个可靠的方法。Objective To evaluate the ability of fluoroscopy in judging the position of screws of sacroiliac joint. Methods The 2. 5mm Kirschner wire was driven into sacroiliac joint of adults fixed cadavers simulating the sacroiliac screws operation to estimate the position of every Kirschner wire with different projections by C arm X-ray fluoroscopy machine,then counting the accuracy of evaluating Kirschner wire for each position. Results 107 successful data were achieved. The times of screw position within the S1 vertebral body,into S1foramen,the anterior aspect of the S1 vertebral body,and in the canal of the S1 vertebra were 38,25,24 and 20 respectively. The accuracy rate of the first group was 92. 1% ,92. 0% ,95. 8% and 90. 0% respectively. The accuracy rate of the second group was 94. 7% ,92. 0% ,91. 7% ,95. 0% respectively. Kappa index was 0. 7861,which explained the reliability of observations. Conclusion The fluoroscopy is a reliable method for judging the position of screws during pelvic surgery.

关 键 词：骶髂关节 螺钉 位置 X线透视检查 

分 类 号：R814.5[医药卫生—影像医学与核医学]