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目的探讨多层螺旋CT(MSCT)一站式检查在胸腹部地震复合伤中的临床应用价值。方法同时行数字化X线摄影(DR)和MSCT检查的胸腹部地震复合伤患者共162例,比较两种检查方法的检查时间、辐射剂量和诊断价值,以优化检查流程并优选检查方法。结果胸腹部地震复合伤影像学检查,MSCT耗时(5±2)min,DR耗时(10±3)min(P<0.001)。胸腹部DR投照总吸收剂量约为(2.4±1.3)mSv,而MSCT的吸收剂量约为(6.4±1.7)mSv,高于DR投照(P<0.001)。对明显的锁骨、肋骨、胸骨、胸椎、腰椎以及骨盆骨折,MSCT和DR均可较好显示;对于肝、胰、脾等软组织脏器的创伤,DR不能显示。MSCT对胸腹部地震复合伤骨折检出的敏感性(98%)和特异性(97%)高于DR(74%,67%)。结论 MSCT一站式检查节约检查时间并且诊断可靠,因此可作为群体应急事件中复合伤的首选检查方法。
Objective To investigate the clinical value of multi-slice spiral CT (MSCT) one-stop examination in the complex injury of thoracoabdominal and abdomen earthquakes. Methods A total of 162 cases of thoracoabdominal seismogenic combined injury with digital radiography (DR) and MSCT were compared. The examination time, radiation dose and diagnostic value of the two methods were compared to optimize the examination procedure and to optimize the method of examination. Results The chest and abdomen earthquake combined injury imaging examination, MSCT time (5 ± 2) min, DR time-consuming (10 ± 3) min (P <0.001). The total absorbed dose of DR for chest and abdomen was about (2.4 ± 1.3) mSv, while the absorbed dose of MSCT was (6.4 ± 1.7) mSv, higher than that for DR (P <0.001). For obvious clavicle, rib, sternum, thoracic, lumbar and pelvic fractures, MSCT and DR can be better displayed; for the trauma of soft tissue organs such as liver, pancreas and spleen, DR can not be displayed. The sensitivity (98%) and specificity (97%) of MSCT were higher than that of DR (74%, 67%) for thoracolumbar seismogenic composite fracture. Conclusion The one-stop MSCT saves time and ensures reliable diagnosis, so it can be used as the preferred method of checking composite wounds in group emergency.