X quang lng ngc

B mn Chn on hnh nh
i hc Y dc Cn Th

Ni dung
Gii phu
Chiu th
Tiu chun k thut
Gii phu X quang
Trnh t c phim
Cm by, xo nh

Gii phu

Chiu th

Th thng sau-trc

Th thng trc-sau

Th nghing tri

Tiu chun k thut

Ton b lng ngc bnh nhn nm trn trn

phim?
T th bnh nhn
Bnh nhn th vo su?
m phim ( xuyn thu tia X) ph hp?
Loi b ht cc d vt ra khi lng ngc

 m bo ton b lng ngc bnh nhn

nm trn trn phim

T th bnh nhn

 m bo bnh nhn th vo su

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 m bo m phim ph hp

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 Loi b ht cc d vt ra khi lng ngc

Gii phu X quang

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Trnh t phn tch

phim X quang

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Cc bc c phim
Hnh chnh
K thut
Chuyn mn

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 Hnh chnh:

Tn, tui, gii tnh.

S h s bnh n.
Phim chp ln th my.
Ni chp phim (khoa, phng, bnh vin).
Ngy, thng, nm chp phim.
nh du tri hay phi

K thut:
Ton b lng ngc bnh nhn nm trn trn

phim?
T th bnh nhn
Bnh nhn th vo su?
m phim ( xuyn thu tia X) ph hp?
Loi b ht cc d vt ra khi lng ngc

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 Chuyn mn:

Xng, phn mm
Vm honh, mng phi
Tim
Trung tht, rn phi
Nhu m

Cm by, xo nh

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Bt thng

Vim phi

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Vim phi
Nguyn nhn : vi khun, virus, nm, x tr,
Tn thng thng tng m
Trn phim X quang khng th chn on tc
nhn gy bnh t hnh nh cc bng m.
Nu iu tr tt, cc du hiu X quang thng
gim dn sau cc du hiu lm sng hai n ba
tun l. N gim dn t ngoi vi vo trung tm.

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p xe phi

Tn thng dng ng c, to hang do nhim

trng.
Mt hoc nhiu tn thng.
Vi khun (Staphylococcus aureus, Klebsiella,
Proteus, Pseudomonas, vi khun k kh), hay
nm l nhng tc nhn thng gp.
X quang c th bnh thng trong 72 gi u.
Thng hin din mc kh dch trong hang.

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 Trc khi m thot:

Hnh m m nhiu hay t, kch thc a dng, c b
vin gii hn khng r, thng gi mt bnh phi
thng thng.

Sau khi m thot:

Hnh mc nc - hi nm ngang khi chp t th
ng. Thnh hang mng v mt trong u. Nu c
iu tr, th tch ca hang gim dn v hnh nh tn
thng quanh hang bin mt.

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 Lao s nhim:
phc hp lao nguyn thy (phc hp Ranke)
Lao sau s nhim:
Lao k
Lao phi thm nhim sm
Lao phi mn tnh:
Lao nt
Lao x hang
Lao x

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 Cc tn thng lao phi thng c c

im:
c hai phi, tp trung nh nhiu hn y
phi (thng phn thy nh hay phn thy
sau thy trn hoc phn thy nh thy di),
nhiu "la tui tn thng",
c th c vi ha,
c th c hch to.

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Vim ph qun mn

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 Lc u:
khng c du hiu trn X quang.
V sau:
dy thnh ph qun v hnh ph n m k

quanh ph qun- mch mu (hnh ph qun

dng vng)
m ng dn kh.
Mun hn:
Hnh nh cc hu qu ca vim ph qun
mn: dn ph qun, tm ph mn,

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Bnh phi tc nghn mn tnh

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 Hnh nh X quang khng c hiu.

M dng ng (dy thnh ph qun):
Hnh nng sng (khi hng tia X pht ra song song

vi nhnh ph qun).
Hnh ng ray xe la (khi hng tia X pht ra vung
gc vi nhnh ph qun).

Gia tng nhng vt phi (hnh nh phi d):

Ni bt nhng vt m dng ng.
Du hiu mang tnh cht cm tnh ch quan ca
ngi c.

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Kh ph thng

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 Gin khu tr, khng hi phc cc ph qun va

v nh.
Nhiu dng:

kh ph thng trung tm tiu thy,

kh ph thng ton b tiu thy,
kh ph thng cnh vch,
kh ph thng cnh so.

ch phn bit c trn CT

Nguyn nhn:
thng do nhim khun.
bm sinh,, tc nghn, x ha phi,

X quang:

Phi tng sng.

Vm honh hai bn h thp, dt.
Chiu cao trn di ca phi > 27 cm.
Cc khoang gian sn gin rng.
i khi xut hin cc bng hi vng nh hoc y
phi.
Vng phi bt thng gim s lng mch mu.
Mch mu phi ngoi vi khng c hoc tha tht.

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Hen ph qun
Hai loi:
hen ngoi lai (th d ng):
tr em,
qu mn min dich trung gian khi ht phi khng
nguyn

hen ni ti:
ngi ln,
khng c qu mn min dch trung gian.

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 Xquang:
X quang bnh thng phn ln bnh nhn
hen.
Hen nng hay mn tnh:
Hnh nh by kh, tng thng kh: vm honh dt,
gia tng khong sng sau xng c.
Gii hn bin c ng vm honh.

Dy thnh ph qun (hnh ng ray xe la):

l mt du hiu khng c hiu

Ung th nguyn pht

Nhng khi u nguyn pht ca cc ph qun

ln thng c pht hin do ri lan v thng

kh (xp phi) hoc do bi nhim. Lc u
khng c du hiu X quang in hnh khi khi u
cha gy hp ph qun.
Cc u nguyn pht ca cc ph qun nh, xa
thng c hnh nh mt bng m trn, to,
ngoi vi, kch thc thay i, b c th r hoc
m hoc hnh gai,

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Lnh tnh

Lnh tnh hoc

c tnh

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 Nhng du hiu chnh ca tnh cht c tnh:

Khi hoc nt: b khng u, ta gai.
Rn phi ph i mt bn.
Hang:
Phn ln thy trn hay phn thy trn th y di.
Thnh hang dy ch im cho c tnh.

Nhng du hiu ph ca tnh cht c tnh:

Xp phi (du ch S ngc khi xp thy

trn phi phi, thy trn phi tri).

Vim phi tc nghn.
Trn dch mng phi.
Tn thng dng m k: u lan theo ng
bch mch.
Hch to vng rn phi v trung tht.
Di cn n phi cng bn, phi i bn.

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 Chp ct lp vi tnh:
thy r s lan ta bch huyt quanh khi u,
hnh di cn ca cc hch rn phi, s xm ln
ra c quan ln cn.
hng dn chc d, sinh thit, gp phn
nh gi bnh nhn c ch nh phu thut
hay khng.

Di cn phi
C ba th:
Hnh m trn duy nht hoc nhiu hnh (th
bong bng bay)
Hnh m nt nh ri rc (th k)
Vim bch mch di cn (th li)

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Trn dch mng phi

Hai dng:
Trn dch mng phi th t do
Trn dch mng phi th khu tr

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Trn dch mng phi (t do)

Phim X quang thng:
Bnh nhn ng hoc ngi:
Lng t: t gc sn honh bn khi lng dch
khong > 175ml.
Lng nhiu: m vng thp, xa b vm honh,
ng cong Damoiseau, xp nhu m phi do
p, y lch trung tht.

Bnh nhn nm nghing bn nghi ng trn

dch, tia X song song bn chp:
Dch tri rng theo khoang mng phi vng thp.
Nhy nht: c th pht hin t nht 25 ml dch.

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Trn dch mng phi (t do)

Phim X quang nghing:
Du hiu t gc sn honh pha sau khi
lng dch khong > 75 ml.

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Trn dch mng phi (khu tr)

Trn dch mng phi di y phi:
y phi b y ln cao.
im cao ca b cong y phi b lch ra
ngoi.
Khng c ng cong Damoiseau.

Trn dch mng phi rnh lin thy:

hnh nh "bu ma".
Trn dch mng phi p trung tht.

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Trn kh mng phi

Phim thng bnh nhn ng:
Vng sng v mch.
Thy c l tng ca mng phi.
Nhu m phi xp li.
Phim thng bnh nhn nm nga:
Du khe su: gc sn honh trc rt r.

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Khi chon ch trung tht

Cc khi chon ch trung tht thng gp
Trung tht trc

Trung tht gia

Trung tht sau

Tuyn gip
Tuyn c
Hch
U qui
Phnh MC ln

Hch
Kn ph qun
Phnh cung MC
Dn tnh mch

U ngun gc thn
kinh
Thot v honh
Dn thc qun
Phnh MC xung

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Cm n bn !

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