分析利用自製輔具針對足部外傷患者的運用

An Analysis of the Use of DIY Assistive Devices for Foot Injury Patients

邱裕盛(Yu-Sheng Chiu) ； 張思涵(Szu-Han Chang) ； 吳茂昌(Mao-Chang Wu) ； 謝品安(Pin-An Hsieh) ； 陳祥元(Hsiang-Yuan Chen)

《中華放射線技術學雜誌》 46卷3期 (2022/09) Pp. 145-151

摘要

急診每日有許多病患因外傷就醫而進行X光檢查，然而在拍攝過程中因患部的疼痛以致部分病患無法配合放射師進行正確擺位，而導致無法順利執行檢查；而本研究即是針對病患因足部伴隨膝部甚至髖關節之急性外傷時，足部X光拍攝上遇到的擺位困難。過去傳統的方式是需把膝關節彎曲才能執行檢查，但此舉往往為病患帶來劇烈的疼痛也降低了配合的意願，增加攝影上的困難也同時影響了診斷。因此我們回溯收集過去主訴為足部受傷的急診案件，並比較放射技師用傳統擺位與使用自製輔具來攝影之差別。將所有影像進行回顧性評估，由放射科醫生個別針對影像品質進行評分，另外記錄總攝影時間比較兩者之差異。本研究通過長庚人體試驗審查委員會，收集過去2020年5月至2020年11月期間70例患者之病歷與影像，其影像品質分數在使用傳統攝影AP VIEW為4.18±0.175而Oblique VIEW為4.08±0.167，而使用自製輔具攝影在AP VIEW為4.92±0.088而Oblique VIEW為4.67±0.110（p＜0.001），總攝影時間在傳統攝影與使用自製輔具攝影分別為174.00±53.42與141.00±41.47秒（p＜0.05）。針對急診足部外傷且不適移動的病患利用自製輔具來拍攝足部X光是較佳的方式，能造成傷患較低的疼痛感，且使用較少的操作時間並能擁有良好的影像品質，進而提升急診X光檢查執行之效率。

關鍵字

自製輔具 ； 急診 ； 足部X光 ； 擺位

並列摘要

In the emergency department, many patients undergo X-ray examinations due to traumatic injuries every day. However, due to the pain of the affected part during the shooting, some patients cannot cooperate with the radiologist to carry out the correct positioning, which makes it impossible to perform the examination smoothly. This research is aimed at the positioning difficulties encountered in foot X-ray photography for patients with acute foot trauma accompanied with knee or even hip joint injuries. In the past, the traditional method was to bend the knee joint to perform the examination, but this often caused severe pain to the patient and reduced the willingness to cooperate, which increased the difficulty of the radiography and also affected the diagnosis. Therefore, we retrospectively collected past emergency cases where the main complaint was foot injuries, and compared the difference between radiographers using traditional positioning and DIY assistive devices for radiography. All images were evaluated retrospectively, and the radiologists scored the image quality individually, and recorded the total shooting time to compare the difference between the two. This study passed the CHANG GUNG MEDICAL FOUNDATION INSTITUTIONAL REVIEW BOARD and collected the medical records and images of 70 patients from May 2020 to November 2020. The image quality score of AP VIEW using traditional radiography was 4.180.175 and Oblique VIEW was 4.080.167., while the DIY assistive device radiography in AP VIEW is 4.920.088 and Oblique VIEW is 4.670.110 (p＜0.001), the total radiography time in traditional radiography and DIY assistive device radiography are 174.00±53.42 and 141.0041.47 seconds respectively (p＜0.05). For patients with foot trauma and unsuitable to move in the emergency department, it is preferred to use DIY assistive devices to take foot X-rays, which can reduce pain for the injured, and costs less operation time to obtain good image quality, and in turn improve the efficiency of emergency X-ray examination.

並列關鍵字

DIY assistive devices ； Foot X-ray ； emergency department ； position