- 期刊
三角型海綿墊應用於急診病患反轉式肩部Y形攝影之探討
Assessment Applied Triangle Sponge Pad to Emergency Patients Reverse Shoulder Y Lateral-Anterior Oblique Position Photography
摘要
遇到肩部外傷的病患，急診外科醫師會先利用一般診斷X光做為初步的檢查與判斷。肩膀外傷系列（shoulder trauma series）X光片一般是使用站立的姿勢；如果病患因嚴重外傷或失去意識，只能躺在檢查台上進行檢查。反轉式肩部Y形攝影（reverse shoulder Y lateral-anterior oblique position）側身動作對於外傷病患常會引起疼痛不舒服導致臨床放射師姿勢擺位上的困難，因此廢片增加進而病人重覆照射次數也增多。因此我們研究藉由輔具來減少側身動作帶來的不適及減少重覆照射的次數。2016年9月到2016年11月間，共納入100位病患：50位採站立姿勢、22位平躺並使用綠單協助檢查、28位平躺並使用三角型海綿墊協助檢查。所有影像皆由放射診斷科專科醫師評分並比較其差異性。使用SPSS 18.0，以成對樣本T檢定（paired sample t test）來進行統計分析。設定雙尾檢定p ＜.01 時有顯著性差異。站立檢查和躺床使用綠單得p =.893；站立檢查和躺床使用三角型海綿墊得p =.782；躺床使用三角型海綿墊與綠單得p =.569。可以得知：此三組影像在醫生的診斷上是無差異性（p ＞.01）的檢查。我們的研究顯示：躺床使用綠單及三角型海綿墊之角度均符合本實驗之要求，但三角型海綿墊較綠單更合適。我們建議善加利用三角型海綿墊減少側身動作帶來的不適及減少照射次數。
並列摘要
While encountering shoulder trauma patients, the ER doctors regularly need conventional X-ray study as the first screening tool to check and evaluate the condition of the shoulder. Standard X-ray of shoulder trauma series is in standing position. However, patients with severe trauma or conscious loss need to lie supine instead. The reverse shoulder Y lateral-anterior oblique position for trauma patients often causes pain or discomfort resulted from difficulties of the clinical posture. We held a study to use assistive device to maintain tilting position for reducing discomfort and the number of repeated exposure. From September of 2016 to November of 2016, we recruited 100 patients in daily practice: 50 patients in shoulder Y lateral-anterior oblique stand position, 22 patients in the reclined posture with folded surgical cloth, and 28 patients in the reclined posture with triangle sponge pad. All images were scored and analyzed by a qualified radiologist. SPSS 18.0 and the paired sample t test were used for statistics and imaging data interpretation. Significant differences was defined as p ＜ .01 by double-tailed test. The results are standing versus reclined posture with folded surgical cloth (p = .893), standing versus reclined posture with triangle sponge pad (p= .782), and reclined position with folded surgical cloth versus reclined position with triangle sponge pad (p = .569). Therefore, there were no statistical significance between X-ray examinations of shoulder trauma series among the three types in doctor's diagnosis (p ＞ .01). Our results showed that the modified reclined posture with folded surgical cloth or triangle sponge pad assistance provided reliable imaging for diagnosis. The triangle sponge pad was better and easier to use than folded surgical cloth. It is recommended to routinely use triangle sponge pad to reduce discomfort and the number of repeated exposure in the daily practice.