北京生物醫(yī)學工程

改良骨科術中側位拍片暗盒固定支架的設計與應用

Design and application of a modified cassettefixation bracketfor the lateral radiograph in orthopedics

作者：李嫚劉寶強周正宏

單位：北京積水潭醫(yī)院手術室（北京 100035） 通信作者：李嫚。E-mail：[email protected]

分類號：R318.04

出版年·卷·期（頁碼）：2021·40·5（516-520）

摘要：

目的針對原有拍片支架易配重失衡和片盒與投射部位距離過大等技術難題，本文提出一種新的骨科術中側位拍片暗盒固定支架。方法支架由五腳不銹鋼底座支架、固定柱、升降柱、手柄式固定螺栓、推進滑軌、滑軌鎖扣、滑軌固定螺栓、防脫螺母、暗盒固定柱、暗盒固定上、下邊框及萬向可鎖定滑動輪組成。在原有骨科側位拍片支架的設計基礎上重新設計五腳不銹鋼底座支架和萬向滑動輪解決配重穩(wěn)定問題；增加可推進暗盒固定滑軌，實現(xiàn)片盒貼近投照部位；增加滑軌鎖扣和滑軌固定螺栓控制推進距離。通過觀察實驗組和對照組一次成像率和影像放大倍數(shù)，驗證本設計的應用效果。結果實驗組拍片時間同對照組比較，無顯著性差異（P＞0.05），但拍片次數(shù)，一次成像率和圖像放大倍數(shù)較對照組有顯著性差異（P＜0.05）。采用改良側位拍片支架相對原有側位拍片支架雖然不能縮短拍片用時，但可以明顯減少拍片次數(shù)，提高拍片的一次成像率和降低圖像放大倍數(shù)。結論采用改良骨科術中側位拍片暗盒固定支架進行側位拍片，可獲得99%的一次成像率和接近1的影像放大倍數(shù)，手術中應用效果滿意，具有良好的臨床應用前景。

Objective In order to solve technical problems such as the easy weight imbalance and the excessive distance between the box and the projection site of the original radiography bracket, this paper proposes a new fixation bracket for lateral radiography in orthopedic surgery. Methods The bracket is composed of a five-leg stainless steel base bracket, a fixing column, a lifting column, a handle type fixing bolt, a pushing slide rail, a sliding rail lock, a sliding rail fixing bolt, an anti-stripping nut, a cassette fixing column, a cassette fixing upper and lower frame and a universal locking sliding wheel. On the basis of the original orthopedic lateral photography bracket design, the five-legged stainless steel base bracket and the universal sliding wheel are redesigned to solve the problem of counterweight stability while the sliding rail is added with a pushable cartridge-box to fix the sliding rail so that the sliding box could be close to the projection position, and the sliding rail lock as well as the sliding rail fixing bolt is added to control the advancing distance. Moreover, the application effect of this design is verified by observing the primary imaging rate and image magnification of the experimental group and the control group respectively. Results The results show that there is no significant difference in filming time between the experimental group and the control group (P＞0.05), but there are significant differences in the shooting times, the first imaging rate and the image magnification (P < 0.05). Compared with the original lateral bracket, though the improved lateral bracket can not shorten the duration of radiography, it can significantly reduce the number of radiography, improve the primary imaging rate and reduce the image magnification. Conclusions The modified orthopedic intraoperative lateral radiography with carrier-fixator is able to achieve 99% of the first imaging rate and nearly 1:1 image magnification, which is satisfactory in operation and has a good clinical application prospect.

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