Radiology:莫要忽视肋软骨骨折,防千里之堤溃于蚁穴!

2018-01-05 shaosai MedSci原创

本研究旨在评价胸部钝器伤行全身CT检查肋软骨(CC)骨折的发病率及CC骨折分布、合并伤、损伤机制、报告准确性及其对30天死亡率的影响,研究人员将结果发表在Radiology上。本研究共查阅了36个月来胸部钝器伤行全身CT的患者资料,并由另一位阅片者对胸部创伤CT进行分析。在1461例行全身CT检查的患者中,39% (574 / 1461)具有胸部损伤(男性为74.0% [425 / 574],平均

本研究旨在评价胸部钝器伤行全身CT检查肋软骨(CC)骨折的发病率及CC骨折分布、合并伤、损伤机制、报告准确性及其对30天死亡率的影响,研究人员将结果发表在Radiology上。

本研究共查阅了36个月来胸部钝器伤行全身CT的患者资料,并由另一位阅片者对胸部创伤CT进行分析。在1461例行全身CT检查的患者中,39% (574 / 1461)具有胸部损伤(男性为74.0% [425 / 574],平均年龄46.6岁,女性为26.0% [149 / 574],平均年龄为26.0%)计算χ 2及OR。利用Cohen kappa值计算观察者间的一致性。

结果为,共有114例患者(男性为86.8% [99 / 114],平均年龄为48.6 岁;女性为13.2% [15 / 114],平均年龄为45.1 years)有221处CC骨折。在全身CT检查和胸部创伤患者的发病率分别为7.8% (114 / 1461) 、19.9% (114 / 574)。第7肋软骨损伤(21.3%, 47/221)是最常见的。双侧多发连续性肋骨骨折在行全身CT的患者与其他胸部创伤患者的发病率分别为36% (41 / 114) 、14% (64 / 460) (OR, 3.48; 95% CI: 2.18, 5.53; P < .0001)。肝损伤是最常见的,在有CC骨折的胸部创伤患者与无CC骨折的胸部患者的发病率为分别(13%, 15 / 114)、(4%, 18 / 460) (OR, 3.72; 95% CI: 1.81, 7.64; P = .0001),其次是主动脉损伤(n = 4 vs n = 0; P = .0015)。观察者检查CC骨折的一致性为0.65.在主要的影像报告中,体现CC骨折的比例为39.5% (45 / 114)。有CC骨折的胸部创伤患者的30天死亡率与无CC骨折的胸部创伤患者的发生率分别为7.02% (8 / 114)、4.78% (22 / 460) (OR, 1.50; 95% CI: 0.65, 3.47; P = .3371)。

本研究表明,胸部钝器伤患者常发生CC骨折,常多见于多发连续性肋骨骨折的患者。有CC骨折的患者主动脉及肝损伤较无CC骨折的患者的发生率要高。

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  2. [GetPortalCommentsPageByObjectIdResponse(id=1926687, encodeId=a21e192668ea0, content=<a href='/topic/show?id=bb3d80891fd' target=_blank style='color:#2F92EE;'>#肋软骨#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=80891, encryptionId=bb3d80891fd, topicName=肋软骨)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=869698, createdName=ligang4439, createdTime=Thu Sep 13 14:37:00 CST 2018, time=2018-09-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=276356, encodeId=ad542e6356ed, content=肋软骨骨折后肝损伤可能性加大.想不明白啊..不过记住了, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/05/06/8605f5ae738e120c1c0f108a4f18398a.jpg, createdBy=0fcc2197920, createdName=放射科的小学生, createdTime=Sun Jan 07 13:26:35 CST 2018, time=2018-01-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=276047, encodeId=0c742e604789, content=学习了谢谢作者分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Sat Jan 06 16:40:39 CST 2018, time=2018-01-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=275774, encodeId=07482e577460, content=学习了受益匪浅, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDicHg2ldsSNmib46PmdzpO7CQEmPjuULp1v45zPWwMYhrnXgvl3OtmUCZSQfgITWn96X9moL94nUGA/0, createdBy=28072041016, createdName=131****1460, createdTime=Fri Jan 05 18:38:01 CST 2018, time=2018-01-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=275747, encodeId=939c2e5747bc, content=学习一下谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzaiabIFicf63hKvVMjL6aJlx4yX4UcXmzX9DyibCRcicq0QtCRWMaQKh8MYjE1D3EKUBopgiaGWYuqbeR/0, createdBy=0c2b1999806, createdName=三生有幸9135, createdTime=Fri Jan 05 15:24:56 CST 2018, time=2018-01-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=275739, encodeId=a9742e5739ff, content=学习了.谢谢分享., beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=60791943465, createdName=1e0f8808m18(暂无匿称), createdTime=Fri Jan 05 14:21:08 CST 2018, time=2018-01-05, status=1, ipAttribution=)]
    2018-01-07 放射科的小学生

    肋软骨骨折后肝损伤可能性加大.想不明白啊..不过记住了

    0

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    2018-01-06 虈亣靌

    学习了谢谢作者分享!

    0

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    2018-01-05 131****1460

    学习了受益匪浅

    0

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    2018-01-05 三生有幸9135

    学习一下谢谢分享

    0

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    2018-01-05 1e0f8808m18(暂无匿称)

    学习了.谢谢分享.

    0

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