梁振

[摘要] 目的 探析CT、X线在胸腰椎骨折上的临床诊断价值，为胸腰椎骨折的；临床治疗提供科学合理依据。方法 方便选取2015年2月—2017年2月该院收治的85例胸腰椎骨折患者为该次研究对象，所有患者在入院后均接受X线、CT检查，且均接受手术治疗，通过对CT、X线检查结果与手术观察结果，对两种检查方式的诊断符合率、胸腰椎骨折分型检出情况、影像学特点进行回顾性分析。结果 经研究发现，在诊断符合率上：以手術观察结果为“金标准”，CT诊断符合率为95.29%，X线诊断符合率为82.35%，CT明显高于X线，两种检查方法的诊断符合率相比差异有统计学意义（P<0.05）；在骨折分型检出情况上：经CT检查单纯屈曲压缩型骨折、安全带型骨折、骨折脱位型骨折的影像学效果均明显高于X线（P<0.05），两种检查技术在爆裂型胸腰椎骨折检出效果上差异无统计学意义（P>0.05）；在影像学特点上，经CT检查患者在椎管狭窄、椎体骨折线、附件骨折、椎弓根间距增宽方面的影像学检出效果均明显高于X线，差异有统计学意义（P<0.05）。结论 在胸腰椎骨折的临床诊断上，相对于X线检查，CT检查的诊断准确率更高，可对胸腰椎骨折的临床分型进行判断。在临床治疗上，采用CT进行临床诊断，可为胸腰椎骨折的临床治疗提供依据，值得进行进一步的应用和推广。

[关键词] 胸腰椎骨折；CT；X线；临床诊断价值

[中图分类号] R5 [文献标识码] A [文章编号] 1674-0742（2017）05（c）-0180-03

[Abstract] Objective To study the clinical value of thoracolumbar vertebral fracture X ray and CT diagnosis and provide the scientific and rational basis for the clinical treatment. Methods Convenient selection 85 cases of patients with thoracolumbar vertebral fractures admitted and treated in our hospital from February 2015 to February 2017 were selected and all patients were examined by the X ray and CT after admission and received the operation treatment， and the X ray examination， operation observation results were compared and the diagnosis coincidence rate， test rate of thoracolumbar vertebral fracture type and imaging features of the two groups were retrospectively analyzed. Results The research showed that the CT diagnosis coincidence rate and X ray diagnosis coincidence rate was respectively 95.29% and 82.35% by taking the operation observation results as the golden standards， and the difference was statistically significant（P<0.05）， and the imaging effect of simple flexion compression fracture， safety belt fracture and fracture dislocation fracture of the CT examination was obviously higher than that of X ray（P<0.05）， and the difference in the test result of burst thoracolumbar fracture between the two examination technologies was not statistically significant（P>0.05）， and the imaging test results of vertebral canal stenosis， fracture of vertebral body， fracture of attachments and widening of pedicle spacing of CT examination was obviously higher than that of X ray， and the difference was statistically significant（P<0.05）. Conclusion The accurate rate of CT examination in clinical diagnosis of thoracolumbar vertebral fractures is higher than that of X ray examination， which can determine the clinical type of thoracolumbar vertebral fractures， in clinical treatment， the CT clinical diagnosis can provide basis for the clinical treatment of thoracolumbar vertebral fractures， which is worth further application and promotion.

[Key words] Thoracolumbar vertebral fractures； CT； X ray； Clinical diagnosis value

胸腰椎骨折是临床上较为常见的骨折类型，主要是指患者受到强大外力作用的影响导致其T11～L2椎体后缘终板粉碎导致骨折。胸腰椎骨折患者骨折类型、脊柱的稳定性以及椎管的狭窄情况可对患者病情造成不同程度的影响，因此，对患者骨折及椎管狭窄的具体情况进行临床检查和诊断，对患者身体恢复有非常重要的意义。目前临床上较为常用的诊断方式主要包括X线、CT技术，X线可显示出患者脊柱排列、曲度和椎间隙的形态，但难以清晰的显示出脊柱后部的骨性结构和椎管形态[1-2]。CT具有分辨率高、可多平面重建、多轴位的特点，显示出胸腰椎骨折患者的解剖全貌，为临床诊断和治疗提供依据。……