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目的研究并总结肋骨骨折首次X线平片检查漏诊的原因,为以后的X线平片检查降低漏诊几率。方法在2017年1月至12月间我院收治的300名肋骨骨折患者中,发生X线平片漏诊22例,对这22例患者的病例进行回顾,分析漏诊原因。结果本次研究样本中共300例患者,发生首次X线平片肋骨骨折漏诊的有22例,漏诊发生率为6.3%。经过其病例回顾可发现,在这22例发生首次X线平片肋骨骨折漏诊的患者中,3名是上部第2肋骨骨折,7名是第4-8肋骨骨折,5名是膈下第10-12肋骨骨折,2名是合并肺气肿肋骨骨折,3例是合并胸腔积液肋骨骨折,2名是合并液气胸肋骨骨折。其骨折病症在患者复查时通过不同方式查出,其中对其加拍斜位片时发现骨折的有5例,痛点定位标记透视下点片发现骨折的有8例,加大曝光条件时发现膈下骨折的有3例,胸腔积液发现骨折的有4例;回顾性阅片发现骨折的有2例。结论诊断肋骨骨折的最常用方法就是进行胸部X线平片检查,为了降低肋骨骨折首次X线平片检查漏诊的概率,需要选择合适的体位,在适当的条件下进行,经过多方面分析后再做胸部X线平片检查,使肋骨骨折的漏诊率尽量得到明显的降低。
Objective To study and summarize the causes of misdiagnosis of the first radiographic examination of rib fractures, to reduce the risk of missed diagnosis for the subsequent radiographic examination. Methods Totally 22 cases of missed diagnosis of rib fractures were treated in our hospital from January 2017 to December 2017. The cases of these 22 patients were reviewed to analyze the causes of missed diagnosis. Results A total of 300 patients in this study sample, the first occurrence of X-ray film rib fracture missed diagnosis of 22 cases, the incidence of missed diagnosis was 6.3%. After a review of his case, 3 of the 22 patients who missed the first X-ray diagnosis of rib fractures were the upper 2 rib fractures, 7 the 4th-8 rib fractures, and 5 the inferior diaphragm 10 -12 rib fractures, 2 were emphysema rib fractures, 3 cases were combined with pleural effusion rib fractures, 2 were merger of liquid-gas pneumothorax rib fractures. The fracture symptoms were detected in different ways during patient review, including 5 cases of fractures found when filming oblique films, 8 cases of fractures found by spotting under the film of pain points, and the diaphragm was found to be enlarged under exposure conditions There were 3 cases of fractures, 4 cases of pleural effusion found fractures; retrospective reading film found in 2 cases of fractures. Conclusion The most common method for the diagnosis of rib fracture is a chest X-ray examination, in order to reduce the probability of the first rib fracture X-ray examination missed, it is necessary to choose the right position, carried out under appropriate conditions, then passes through the various analysis To do chest X-ray examination, the rate of missed diagnosis of rib fractures try to get significantly reduced.