CAJ | 학술논문

目的对氟骨症前臂和小腿X线征象及其诊断价值进行再研究和认识,为地方性氟中毒(简称地氟病)病区X线普查或检测正确实施易减部位提供科学依据.方法应用自行研制的防护罩、暗室等便携式专用装置配合小型X线机对地氟病病区1440例受检者进行X线摄片,确诊氟骨症384例,并以此为样本,分析对比观察其前臂和小腿肘、膝关节及长骨骨干X线改变时间、X线改变程度、X线改变范围等项内容的差异,评价它们诊断作用的大小,正确作出部位选择.结果前臂肘关节改变先于小腿膝关节,其中骨小梁改变为最早,分别检出197、157例,两者比较差异有统计学意义(x2=8.385,P＜ 0.01).前臂骨干骨间膜骨化比小腿早,多见于Ⅰ度照片,分别为213例和126例,两者比较差异有统计学意义(x2=17.626,P＜ 0.01).骨间膜骨化演变方向是从前臂桡骨始至尺骨,在向小腿胫骨至腓骨蔓延,并伴随前臂加重而改变；观察多种指标,尤其是骨关节骨小梁改变和长骨骨干骨间膜骨化的表现最为活跃,且前臂比小腿异常敏感、明显.结论在地方性氟中毒病区X线普查或检测中,选择前臂取代小腿摄片是简便、经济、快速、有效的诊断方法.
목적 대불골증전비화소퇴X선정상급기진단개치진행재연구화인식,위지방성불중독(간칭지불병)병구X선보사혹검측정학실시역감부위제공과학의거.방법 응용자행연제적방호조、암실등편휴식전용장치배합소형X선궤대지불병병구1440례수검자진행X선섭편,학진불골증384례,병이차위양본,분석대비관찰기전비화소퇴주、슬관절급장골골간X선개변시간、X선개변정도、X선개변범위등항내용적차이,평개타문진단작용적대소,정학작출부위선택.결과 전비주관절개변선우소퇴슬관절,기중골소량개변위최조,분별검출197、157례,량자비교차이유통계학의의(x2=8.385,P＜ 0.01).전비골간골간막골화비소퇴조,다견우Ⅰ도조편,분별위213례화126례,량자비교차이유통계학의의(x2=17.626,P＜ 0.01).골간막골화연변방향시종전비뇨골시지척골,재향소퇴경골지비골만연,병반수전비가중이개변；관찰다충지표,우기시골관절골소량개변화장골골간골간막골화적표현최위활약,차전비비소퇴이상민감、명현.결론 재지방성불중독병구X선보사혹검측중,선택전비취대소퇴섭편시간편、경제、쾌속、유효적진단방법.
Objective To study the X-ray signs of forearm and leg in skeletal fluorosis and its diagnostic value,aim at finding the easy examination parts.Methods One thousand four hundred and forty subjects were examined using developed shield,darkroom and other portable dedicated device combined with a small X-ray machine.A total of 384 cases were diagnosed skeletal fluorosis.All patients were divided into different groups and the time,degree and range of X-ray to the forearm and calf elbow,knee,and long bone were compared.Results The X-ray change in the forearm elbow was earlier than that of the leg knee,and trabecular bone change was the earliest indicator,197 cases and 157 cases,respectively,and the difference was statistically significant (x2 =28.006,P ＜ 0.01).Membrane ossification of forearm backbone was earlier than that of the leg,and most of them were degree Ⅰ photos,213 cases and 126 cases respectively.The difference was statistically significant (x2 =17.626,P ＜ 0.01).The direction of the interosseous membrane ossification was from the forearm radius to the ulna,then to the fibula and tibia,and was accompanied by changes in the aggravation of forearm.A variety of indicators were observed,especially the membrane ossification in bone and joint trabecular bone and the long bone was the most active,and the forearm was more sensitive,obviously than that of the calf.Conclusion In the X-ray screening or detection of endemic fluorosis,the forearm radiography is a simple,economical,and effective diagnostic method.