颈椎仰卧水平侧位X线投照技术和临床应用效果分析

来源:用户上传      作者:贾一鸣，段广闻，倪静

　　摘要：目的：探讨颈椎仰卧水平侧位在临床应用中的价值。方法：筛选因颈部外伤无法站立患者100例及颈椎术后无法配合常规直立式颈椎侧位拍摄检查患者100例，共计200例均改为颈椎仰卧水平侧位进行检查，对其检查图像进行质量评估。结果：综合图像质量分析统计，颈椎C1-C4节段椎体平均显示率为96.3%;C5-C6节段椎体平均显示率为52%;C7-T1节段椎体平均显示率为33%;经过辅助双肩定向负重牵拉后，C5-C6节段及C7-T1节段椎体显示率均有提升（81.5%、57.5%），差异具有统计学意义（P<0.05）。结论：颈椎仰卧水平位检查方式在颈外伤及颈椎术后患者中可更好地解决无法直立配合检查的问题，为患者带来便捷，减少检查过程中的疼痛，为制订临床诊断治疗方案提供指导。
　　关键词：数字化X线摄影，外伤性，颈椎;拍摄体位;颈椎病
　　中图分类号：R455.4 文献标识码：A DOI：10？郾3969/j.issn.1001-0270.2022.01.07
　　Analysis of X-ray Projection Technique and Clinical Application in Supine Lateral Position of Cervical Spine
　　JIA Yi-ming， DUAN Guang-wen， NI Jing
　　（Department of Radiology and Nuclear Medicine， Changzheng Hospital of Naval Medical University， Shanghai 200003， China）
　　Abstract： Objective： To explore the value of the cervical vertebrae supine horizontal lateral position in clinical application. Methods： A total of 200 patients， of which 100 could not stand due to neck trauma and another 100 could not cooperate with conventional upright cervical lateral imaging examination after cervical vertebrae surgery， were screened out and changed to cervical vertebrae supine horizontal lateral position for examination. The image quality of the examination was evaluated. Results： Combining the analysis and statistics of the image quality， the average display rate of cervical vertebrae in C1-C4， C5-C6， and C7-T1 segments was 96.3%， 52%， and 33%， respectively. After assisted shoulder directional weight-bearing traction， the display rate of cervical vertebrae in C5-C6 and C7-T1 segments both increased （81.5% and 57.5%）， and the difference in the increase was statistically significant （P<0.05）. Conclusion： In a summary， the cervical vertebrae supine horizontal lateral position can better solve the problem of not being able to stand upright and cooperate with the examination in patients with cervical trauma and after cervical vertebrae surgery， which brings convenience to patients， reduces patients’ pain during the examination， and provides some guidance for the clinical diagnosis and treatment plan.
　　Key Words： Digital radiography; Traumatic; Cervical Vertebra; Camera position; Cervical spondylosis
　　i椎是颈部主要支撑结构之一，由骨骼、韧带及周围软组织构成整体，其内部伴有中枢神经及供给血管通过。随着脊柱外科的手术发展及内固定手术器械的进步，侧块螺钉和椎弓根螺钉内固定技术广泛应用并且越来越完善，为创伤性和非创伤性颈椎患者的内固定手术方式奠定了基础。椎弓根螺钉由于其独特的生物力学及强度优势，越来越多地应用于颈椎创伤、退行性颈椎病、颈椎肿瘤等疾病的治疗[1]。颈椎疾病临床主要表现为疼痛、肿胀、不能自主活动等，车祸、重力打击等外伤可导致脊髓震荡，严重时可能有长期脊髓损伤而使患者不能自主活动。很多就诊患者在接受影像学检查时无法配合。所以本文旨在解决检查时，如何减少搬动、位移情况下使检查方便快捷并且图像质量能达到临床诊断标准。
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