山东省地方性氟中毒病区X线检查成像质量的评价  

Evaluation of imaging quality of X-ray films of endemic fluorosis in Shandong Province

作　　者：张霞[1] 李亨祥[1] 陈培忠[1] 翟丽萍[1] 

机构地区：[1]山东省地方病防治研究所甲状腺疾病防治中心,济南250014

出　　处：《中华地方病学杂志》2014年第2期216-219,共4页Chinese Journal of Endemiology

基　　金：山东省医药卫生科技发展计划资助项目（2013WS0175、HL086）;中央补助地方公共卫生专项资金地方病防治项目（2008）;济宁市科技发展计划资助项目（2009-56）

摘　　要：目的评价山东省地方性氟中毒（地氟病）病区x线检查成像质量，为正确实施x线检查提供依据。方法在山东省20个地氟病县（市、区）各选择3个病村作为调查点，X线拍摄村民的前臂（包括肘关节）和小腿（包括膝关节）正位片，每村拍摄20张，每张包括2个拍摄部位。其中14个县（市、区）的42个病村X线检查由山东省地方病防治研究所承担，共拍摄X线片840张，编为A组，其余6个县（市、区）由当地医院拍摄X线片360张，编为B组。依照检查技术要求和诊断指标来确定X线片审片项目，分照片表面缺陷、结构缺陷、综合质量三个层面对比观察A与B组X线片质量差异。结臬在照片表面缺陷评定中，A组缺陷指标总检出率前臂片为7．98％（67／840），小腿片为9．77％（82／840）；B组分别为35．27％（127／360）和39．16％（141／360），两组比较差异有统计学意义（x。值分别为138．6、144．0，P均〈0．01）。在照片结构缺陷评定中，A组结构缺陷总检出率前臂片为7．14％（60／840），小腿片为8．33％（70／840）；B组分别为27．22％（98／360）和31r38％（113／360）。两组比较差异有统计学意义（x。值分别为88．867、103．6，P均〈0．01）。在照片综合质量评定中，A组优质率前臂片为72．73％（611／840），小腿片为71．67％（602／840），而质差率分别为9．89％（83／840）和11．43％（96／840）：B组优质率为44．14％（159／360）和42．22％（152／360），质差率为34．74％（125／360）和38．06％（137／360），两组比较差异有统计学意义（Z值分别为-20．161、-16．229，P均〈0．01）。结论由县（市、区）自拍摄的X线片缺陷较多、图像较差，其原因与当地医院X线技师技术水平参差不齐，照片质量要求不严有关，应定期成立上级专业技师监管队伍，到现场督导摄片和审片，推行以防治单Objective To evaluate the photo quality of X-ray films of endemic fluorosis in Shandong Province, and to provide a basis for correct implementation of X-ray examination. Methods Three villages were selected as survey sites in each of the 20 endemic fluorosis counties （cities, districts） of Shandong Province; anteroposterior X-ray films of the villagers forearm （including elbow） and leg （including knee） were taken; 20 films were taken in each village, each film comprising two recording sites. X-ray examination carried out in the 42 patients＇ villages of 14 counties（cities, districts） were undertaken by the Institute for Endemic Disease Control, Shandong Province, a total of 840 X-ray films shoot, which was edited group A, and the remaining six counties （cities, districts） were undertaken by the local Hospital, shooting X-ray films 360 copies, compiled for group B. The quality of X-ray film examination was determined in accordance with technical requirements and diagnostic indicators. The difference of photo quality between group A and group B was compared at three levels ： sub-surface defects photos, structural defects and comprehensive quality. Results In evaluation of surface defects in the photo, the total detection rate of the defects indicators in group A of forearm was 7.98%（67/840）, while the rate of leg was 9.77% （82/840）. And the rates of group B were 35.27% （127/360） and 39.16% （141/360）, respectively, and the differences were statistically significant between the two groups（xforearm = 138.6, P 〈 0.01 ; Xleg = 144.0, P 〈 0.01 ）. In assessment of structural defects, the total forearm defection rate of group A was 7.14%（60/840）, and the leg was 8.33%（70/840）. And the rates of group B were 27.22% （98/360） and 31.38%（113/360）, respectively. The differences were statistically significant（x2 forearm = 88.867, P 〈 0.01; X2leg = 103.6, P 〈 0.01）. In the photo quality comprehensive assessment, the excellent rate of forearm in group A was 72.7

关 键 词：氟化物中毒 氟骨症 X线 

分 类 号：R599[医药卫生—内科学]