中华地方病学杂志
中華地方病學雜誌
중화지방병학잡지
Chinese Journal of Endemiology
2014年
2期
216-219
,共4页
氟化物中毒%氟骨症%X线
氟化物中毒%氟骨癥%X線
불화물중독%불골증%X선
Fluoride poisoning%Osteofluorosis%X-ray
目的 评价山东省地方性氟中毒(地氟病)病区X线检查成像质量,为正确实施X线检查提供依据.方法 在山东省20个地氟病县(市、区)各选择3个病村作为调查点,X线拍摄村民的前臂(包括肘关节)和小腿(包括膝关节)正位片,每村拍摄20张,每张包括2个拍摄部位.其中14个县(市、区)的42个病村X线检查由山东省地方病防治研究所承担,共拍摄X线片840张,编为A组,其余6个县(市、区)由当地医院拍摄X线片360张,编为B组.依照检查技术要求和诊断指标来确定X线片审片项目,分照片表面缺陷、结构缺陷、综合质量三个层面对比观察A与B组X线片质量差异.结果 在照片表面缺陷评定中,A组缺陷指标总检出率前臂片为7.98％(67/840),小腿片为9.77％(82/840);B组分别为35.27％(127/360)和39.16％(141/360),两组比较差异有统计学意义(x2值分别为138.6、144.0,P均＜0.01).在照片结构缺陷评定中,A组结构缺陷总检出率前臂片为7.14％ (60/840),小腿片为8.33％ (70/840);B组分别为27.22％ (98/360)和31.38％(113/360),两组比较差异有统计学意义(x2值分别为88.867、103.6,P均＜0.01).在照片综合质量评定中,A组优质率前臂片为72.73％(611/840),小腿片为71.67％ (602/840),而质差率分别为9.89％(83/840)和11.43％ (96/840);B组优质率为44.14％(159/360)和42.22％ (152/360),质差率为34.74％(125/360)和38.06％ (137/360),两组比较差异有统计学意义(Z值分别为-20.161、-16.229,P均＜0.01).结论 由县(市、区)自拍摄的X线片缺陷较多、图像较差,其原因与当地医院X线技师技术水平参差不齐,照片质量要求不严有关,应定期成立上级专业技师监管队伍,到现场督导摄片和审片,推行以防治单位为主体的流动X线检查,以便提供可靠的技术保障.
目的 評價山東省地方性氟中毒(地氟病)病區X線檢查成像質量,為正確實施X線檢查提供依據.方法 在山東省20箇地氟病縣(市、區)各選擇3箇病村作為調查點,X線拍攝村民的前臂(包括肘關節)和小腿(包括膝關節)正位片,每村拍攝20張,每張包括2箇拍攝部位.其中14箇縣(市、區)的42箇病村X線檢查由山東省地方病防治研究所承擔,共拍攝X線片840張,編為A組,其餘6箇縣(市、區)由噹地醫院拍攝X線片360張,編為B組.依照檢查技術要求和診斷指標來確定X線片審片項目,分照片錶麵缺陷、結構缺陷、綜閤質量三箇層麵對比觀察A與B組X線片質量差異.結果 在照片錶麵缺陷評定中,A組缺陷指標總檢齣率前臂片為7.98％(67/840),小腿片為9.77％(82/840);B組分彆為35.27％(127/360)和39.16％(141/360),兩組比較差異有統計學意義(x2值分彆為138.6、144.0,P均＜0.01).在照片結構缺陷評定中,A組結構缺陷總檢齣率前臂片為7.14％ (60/840),小腿片為8.33％ (70/840);B組分彆為27.22％ (98/360)和31.38％(113/360),兩組比較差異有統計學意義(x2值分彆為88.867、103.6,P均＜0.01).在照片綜閤質量評定中,A組優質率前臂片為72.73％(611/840),小腿片為71.67％ (602/840),而質差率分彆為9.89％(83/840)和11.43％ (96/840);B組優質率為44.14％(159/360)和42.22％ (152/360),質差率為34.74％(125/360)和38.06％ (137/360),兩組比較差異有統計學意義(Z值分彆為-20.161、-16.229,P均＜0.01).結論 由縣(市、區)自拍攝的X線片缺陷較多、圖像較差,其原因與噹地醫院X線技師技術水平參差不齊,照片質量要求不嚴有關,應定期成立上級專業技師鑑管隊伍,到現場督導攝片和審片,推行以防治單位為主體的流動X線檢查,以便提供可靠的技術保障.
목적 평개산동성지방성불중독(지불병)병구X선검사성상질량,위정학실시X선검사제공의거.방법 재산동성20개지불병현(시、구)각선택3개병촌작위조사점,X선박섭촌민적전비(포괄주관절)화소퇴(포괄슬관절)정위편,매촌박섭20장,매장포괄2개박섭부위.기중14개현(시、구)적42개병촌X선검사유산동성지방병방치연구소승담,공박섭X선편840장,편위A조,기여6개현(시、구)유당지의원박섭X선편360장,편위B조.의조검사기술요구화진단지표래학정X선편심편항목,분조편표면결함、결구결함、종합질량삼개층면대비관찰A여B조X선편질량차이.결과 재조편표면결함평정중,A조결함지표총검출솔전비편위7.98％(67/840),소퇴편위9.77％(82/840);B조분별위35.27％(127/360)화39.16％(141/360),량조비교차이유통계학의의(x2치분별위138.6、144.0,P균＜0.01).재조편결구결함평정중,A조결구결함총검출솔전비편위7.14％ (60/840),소퇴편위8.33％ (70/840);B조분별위27.22％ (98/360)화31.38％(113/360),량조비교차이유통계학의의(x2치분별위88.867、103.6,P균＜0.01).재조편종합질량평정중,A조우질솔전비편위72.73％(611/840),소퇴편위71.67％ (602/840),이질차솔분별위9.89％(83/840)화11.43％ (96/840);B조우질솔위44.14％(159/360)화42.22％ (152/360),질차솔위34.74％(125/360)화38.06％ (137/360),량조비교차이유통계학의의(Z치분별위-20.161、-16.229,P균＜0.01).결론 유현(시、구)자박섭적X선편결함교다、도상교차,기원인여당지의원X선기사기술수평삼차불제,조편질량요구불엄유관,응정기성립상급전업기사감관대오,도현장독도섭편화심편,추행이방치단위위주체적류동X선검사,이편제공가고적기술보장.
Objective To evaluate the photo quality of X-ray films of endemic fluorosis in Shandong Province,and to provide a basis for correct implementation of X-ray examination.Methods Three villages were selected as survey sites in each of the 20 endemic fluorosis counties (cities,districts) of Shandong Province;anteroposterior X-ray films of the villagers forearm(including elbow) and leg(including knee) were taken; 20 films were taken in each village,each film comprising two recording sites.X-ray examination carried out in the 42 patients' villages of 14 counties(cities,districts) were undertaken by the Institute for Endemic Disease Control,Shandong Province,a total of 840 X-ray films shoot,which was edited group A,and the remaining six counties (cities,districts) were undertaken by the local Hospital,shooting X-ray films 360 copies,compiled for group B.The quality of X-ray film examination was determined in accordance with technical requirements and diagnostic indicators.The difference of photo quality between group A and group B was compared at three levels:sub-surface defects photos,structural defects and comprehensive quality.Results In evaluation of surface defects in the photo,the total detection rate of the defects indicators in group A of forearm was 7.98％(67/840),while the rate of leg was 9.77％(82/840).And the rates of group B were 35.27％(127/360) and 39.16％(141/360),respectively,and the differences were statistically significant between the two groups(x2forearm=138.6,P ＜ 0.01 ; x2leg =144.0,P ＜ 0.01).In assessment of structural defects,the total forearm defection rate of group A was 7.14％(60/840),and the leg was 8.33％ (70/840).And the rates of group B were 27.22％ (98/360) and 31.38％ (113/360),respectively.The differences were statistically significant(x2forearm =88.867,P ＜ 0.01; x2leg =103.6,P ＜ 0.01).In the photo quality comprehensive assessment,the excellent rate of forearm in group A was 72.73％(611/840),and the leg was 71.67％ (602/840),while the poor quality rates in the same parts were 9.89％ (83/840) and 11.43％ (96/840),respectively.And the excellent rates of Group B were 44.14％(159/360) and 42.22％(152/360),poor quality rates were 34.74％(125/360) and 38.06％(137/360).The differences were statistically significant(Z value were-20.161 and-16.229,respectively,P ＜ 0.01).Conclusions X-ray films taken in the counties (cities,districts) have more defects,and image is poor.The reason for that is that the skill levels of local hospital X-ray technician are low,and photos quality is not strictly followed requirements.Supervision team of professional technicians should be established to provide professional supports.It is more important to take mobile X-ray examination by the provincial institutes,and to provide a reliable technical support.
