多体位X线摄影检查在肋骨骨折诊断中的应用价值分析  

Application Value of Multi-position X-ray Examination in the Diagnosis of Rib Fracture

作　　者：潘兴龙 Pan Xinglong(Liping County Gaotun Street Health Center,Qiandongnan Miao and Dong Autonomous Prefecture 557318,Guizhou Province,China)

机构地区：[1]黎平县高屯街道卫生院,贵州黔东南苗族侗族自治州557318

出　　处：《中国社区医师》2024年第13期72-74,共3页Chinese Community Doctors

摘　　要：目的:探讨多体位X线摄影检查在肋骨骨折诊断中的应用价值。方法:选取2021年1月-2023年1月黎平县高屯街道卫生院收治的疑似肋骨骨折患者37例作为研究对象,均进行多体位X线摄影检查,观察肋骨骨折多体位X线摄影的图像特征,以临床综合诊断结果为“金标准”,计算多体位X线摄影检查诊断肋骨骨折的灵敏度、特异度、阳性预测值、阴性预测值、准确率、漏诊率、误诊率,分析其与临床综合诊断结果的一致性。结果:经临床综合诊断,37例受试者确诊肋骨骨折29例。多体位X线摄影显示,肋骨弯曲、变形或移位,胸壁肌肉肿胀、胸腔积液或气胸,骨折线呈直线或曲线,骨痂表现为骨折线周围密度增高的影子。多体位X线摄影检查诊断肋骨骨折的灵敏度为86.21%(25/29),特异度为62.50%(5/8),阳性预测值为89.29%(25/28),阴性预测值为55.56%(5/9)、准确率为81.08%(30/37),漏诊率为13.79%(4/29),误诊率为37.50%(3/8),其与临床综合诊断结果的一致性一般(Kappa=0.475,P<0.001)。结论:多体位X线摄影可以清晰显示肋骨骨折部位、骨折端的移位情况,诊断准确率尚可,在临床实践中,还需结合患者的病史、体格检查结果和其他辅助检查结果进行综合评估,以确定最佳治疗方案。Objective:To explore the application value of multi-position X-ray examination in the diagnosis of rib fracture.Methods:Thirty-seven patients with suspected rib fracture admitted to Liping County Gaotun Street Health Center from January 2021 to January 2023 were selected as the study objects,and all of them underwent multi-position X-ray examination.The image features of multi-position X-ray of rib fracture were observed.The sensitivity,specificity,positive predictive value,negative predictive value,accuracy rate,missed diagnosis rate and misdiagnosis rate of multi-position X-ray examination in the diagnosis of rib fracture were calculated with the clinical comprehensive diagnosis result as the"gold standard".The consistency between the results and clinical diagnosis was analyzed.Results:After comprehensive clinical diagnosis,29 of 37 subjects were diagnosed with rib fracture;multi-position radiographs show curved,deformed,or displaced ribs,swelling of chest wall muscles,pleural effusion,or pneumothorax,straight or curved fracture lines,and callus as a shadow of increased density around the fracture line;the sensitivity of multi-position X-ray imaging in diagnosing rib fractures was 86.21%(25/29),specificity was 62.50%(5/8),positive predictive value was 89.29%(25/28),negative predictive value was 55.56%(5/9),accuracy was 81.08%(30/37),missed diagnosis rate was 13.79%(4/29),and misdiagnosis rate was 37.50%(3/8),the results were generally consistent with comprehensive clinical diagnosis(Kappa=0.475,P<0.001).Conclusion:Multi-position X-ray can clearly show the displacement of the fracture site and fracture end of the rib fracture,and the diagnostic accuracy is reasonable.In clinical practice,comprehensive evaluation should be carried out in combination with the patient's medical history,physical examination results and other auxiliary examination results to determine the best treatment plan.

关 键 词：多体位X线摄影 肋骨骨折 诊断效能 

分 类 号：R816.8[医药卫生—放射医学]