CIAl PHAU XUONC DUI Ul xiro g dai nhf'l cua bQ xuo g, gl~lco mot than va hai dftu.. L6i cftu tro g va ngoai t~p khop voi rnam chfty tu n Crng.Ii~n khop ran J'< C dtnroc tiep kho voi x o
Trang 1PGS.TS PHAM MINH THONG
chu bi en
,
NHA XUAT BAN Y HQC
HA NOI
Trang 2XU'O'ng dui
I CIAl PHAU XUONC DUI
Ul xiro g dai nhf'l cua bQ xuo g, gl~l(co mot than va hai dftu Than x cn g rn 3 mfit(xau ngoai s u tro g V~lsau truoc) vii 3 bo (ngoai, trong va saul
I)frU trcn x c g dui g m co CClvi, c om x o g Cham xirung ti~p k o vdi 6 c0i
x o g C h ~I U tao thanh khop hang l lai mau chuycn Io va be, giC(ahai mau chuycn I~l.u n lien mau
Dftu duoi x o g dui h i con va ra sau L6i cftu tro g va ngoai t~p khop voi rnam
chfty tu n Crng.I)i~n khop ran J'< ) C dtnroc tiep kho voi x ong banh che
II.CHi D!NH CHl)P
A Chan thuonq
1.Gay than xuung dui
Xiro g dui n m tro g kh6i co Ian diroc nhi~u mach mau nuoi du n nen li nnhanh nhirng trai lai g~y xl( n dui thUd g chay nhif:u mflu co th~ gay s6e milt
Trang 3Bai 1.Xuong dui 5
:;::: , ;: ) ,.
2 Gay tren lot '~1I11xlidng elm
G ~y t r e n 1 6 i c ~ x o g dui thir o g d t a i nan C)t o, do n a cao, d ay 1 rE mtluru ];
it g~p , Khi th i im kh a m can ph a t hi e n d ~ u hi ~ lIthirong rE mth ~ k inh h o g k h co V ~ It6 thiro g mach mau
Tham k [ 1I11X - qu a n c lin g chup hai nr Ih ~ Ih ~ g va n hicn d xac dinh /1 g~y
vamire dQb] lcch,
B Chup xuonq dul phuc vu eho dieu tr]
G ~y x ir o g dui c() c hi dinh d i ~ tri d n dinh n i tu y : V a i Il'l c u a X -qu a n lu c n ay
1 xac dinh vu n g l ily r o g h ay h e p d ~ch n 1 1inhn Q i t l y phi: h e,J p ,
Danh gia tinh trang li~n xuong sau di~u tr]:
_ Phuon g phap di ~ tri d n dinh noi t Y n uQc d o g cho k ~t qu a t 6 1 Sa u
m o t th (' li g i a n (2-3 tu ~ ), ch\1p X-qu a n xlf d g dui ltr lnh g i a tlnh tr"l1lg li e n
xu d g llC' c o hlf d g di ~ u tr\ thleh h <, p ,
_ N~ ll nlH( g5y x t( o g U lli kh o g co ch i l 1jnh ph ~ u thu 0 1 c h i b b t sa t! k hi <Iii
u il th( ' li g ian ( kh o~ m g 6 tu ~ ), Tnt t f c khi lh ao b Q t li t' n h a nh C h~IPl <;l i \I( l n Ulli , nh :) 11a\nh so b Q v s ~ li ~ X lt <1 ll g.c an Xlt C ln g 6 g~y ,
c Cae ton thU'O'I1gkhac
Ch ~ aoa n v i 0 11l x l tO n , u x ll o g, 1 a n XI( <1 n ,
M~c du d a ut( ,le t h ay t h ch i n do a n b t ng chl,lp d t IdP v i tinh nhun g X· q a n
th u n q y v; n) co n n g ye n gia tr \ VI r e l ~ n. cI~th~tc hi ~ n, v tt a g iup c h A n , 1 1; lnV~I
th eo d i tr o g qua trlnh di ~ u t ri , Trong nhCtn g t r udn g h Q P n ay, th a m kh a m X- qu an b t bUQc ph a i c lwP 2tu th ~: th ~ ng va n hi 0 g ,
III KY THuAT CHUP XUONG DUI
A Ky thu~t chl;lP xU'O'I1gdui th~ng ( H1nh 1-1 )
_ B ~ nh nh f ll1 n m ngv a t re n b a n X-qll a n , Ch a n be n c~ n c hl,lp d 6i t h f ll1 g ,h;\ll
c h a n x(1ay nh ~ VaGt r o g ( n u g§.y kh o g h a n t oa n ) ,
_ Ph i m ~O x4 0 e m , d~t d Q c du d i , 1 ' li,"h l nh ai ~ m g ilt a x lt d g alii V ; ll ) g iL(" phim kllu tru c hLlm ti a h o~c c h e 1't c h n ch I t h eo e h i~ u d Qc.
_ Tia trllng Hlm: e hi ~ u vu o g goc Itf 11'011 x 6 g qu a di ~ m g ilf a ( 1ll ivito I un g
Trang 46 Ch 1.Ky thu~t chup X-quangxuonq khop chi dU'O;
htng s(J hu (kV, m/vs)
- Tro g truu g h9P g§y XL,dlg d i duoc cti~ tri bftn UllIlgctinh n i tLIY,dindanh gia kich thuoc th~ c u ong t u , thi phai ct ~ tphim sat vao dui, b n X-
quan ctC'khoan each xa Ii,1,5 ct~ 2 m
- Phai U l y d LI <_:j C mot d an g1Yhoac mOL kho gf ll1 n ~ t ncu ch p khu tru
111 1 11) ' C J(J(J
Hinh 1-1 Ky thu$t c h~p xuCjngQuith ~ ng , tia trung tam vuong goc a Q i~ mgiO'aQui v ao g i O'aphim
B Ky thuat chup xuonq dui nghieng
- Benh nh.in ntm n hicug h an roan tre b n X-qu n , \'~ p i a b n c~n chup,
g6i ct~m ml,lc ctich ct ~x dng ctui sat phim Ch n be c \lp g~p l~i d~n ra
g?P nht,: va xoa ra n ui sao c o m~t ngoai a vilo p im Ch n b n c!6i
di~n g?P g6i ct~t ba c a thin goc xu6ng b n Hunui~m ti c6 ctinh c o tll
th~
Trang 5Bai 1.X U ' 0 11g dui 7
- Phim 30x40 em, d~t doc diroi dui, chinh di~m gili'a xiro g dui VaG giira
phim, khu tru chum ta hoac chc I1ch n chi th a chien doc
Hlnh 1-2. Ky thu$ t chuo xLidng aUi , ur the nqhi e ng ngoai hoan toa n (A) va khong hoan t o an
( 8 ) , t i a trung tam chieu vuong qoc qua ai§ m giu ' a aui va van trung tam ph i m
tam phim
Trang 68 Ch 1, Kythu~t chypX-Quang xU'O'I1gkhop chidU'Qi
c o g I11ll
2 Ky thu~t chup IIghicn tro g (l lnh 1-3)
- Du c ap dung tr o g n ir g uucn h pchan tlnrong n~lIg,
Trang 7XU'O'ng cang chan
I. GIAI PHAUXUONC CANG CHAN (Hlnh 1-4)
II.cAc CHi D!NH CHl,JPXUONG CANG CHAN
- Phat hie llilCfng1 n thiro g gfty xtro j; c:~ll1gchan
- Theo d i l1hnh gia Ii~n x o g sau be h(l ho(tc phi'iu thuat
- Tim nhirn]; t A n thiro g b nh ly: v i e rn IIxir ng
III KY THU,~T CHl,JPXUONG CANG CHAN
A Ky thuat chup th~ng(Hinh 1-5 )
- Benh nhan n~m ngira tren ban Xvqu a n g, chan cAn Chl.IP du6i th~n , him
chan xoay nhe vao trong (d~ tach dVc;1Ct6i da hai x o g chay mac)
- Phim 3 xdO ern, l1~t doc dlfdi d g ( ' 11 ;1 11. chinh d g ('han V ; lO trung 1 ; 1 111
p irn, khu II'llchurn tia hofic chc 1&ch il1 ('hi thea chi~ll doc
- Tin trung film: chi0u th;1 g t r trcn Xlll:'llg v o g gee vtli phirn, khu tru " i )
di~m giira xlfd g dn chan, dphia n)!.11;'1i ('ich h,'j tnroc xu ng chay kho.in
Trang 810 ChI Kythuat chup X-quang xuono khop chi dU'O;
Nh i n t ruce ,, Go g l a 1 1 ca u
Trang 9Bal 2.XU'011gdng chan 11
~ Phlrn
Hinh 1-5.
- Phim 30x,W em, u~t doc dirdi dng Ch:"lI1, chinh dJ\g chan VaG trung tflm
p im, khu tru chum tia h ac che la chftn chi thea chiu d c,
_ Tia trung tilm: chi6 v o g g6c tl'li di0m giLrad g chan dm~t sau xirung
chay "i l( \trung tam phim
_ Thong 'i ichup: 4)4R kY, 2 mA:- I()Oem kho g dtll1g lr(Jic o g 1 11(!.Liru y : Chup ph:ii l~yd oc mot kh p tCI~'thco vi tri 16n iluron rna ta l~y khrtp
g~n do N~l1 ncp boc kim loai 1h1 bo 1':1 N0 b h(l thi t~n tho g s6 chup
Trang 1012 ChI Ky thu~t ch~p X-quang xU'ong kh61~_c_hi_d_u'_6i _
Hlnh 1-6 Ky thu$t chup xLidng c~ng ch a n nghieng , i a trung tam th~ng goc toi ai~m giCtac~ng
chan(jmat sau xU ' ongchay
Trang 11Khop hang
I GIAI PHAU KH()'P HANG
Khop ha g dlfC.1('tao hCi c orn xirc g dLli ti, p khop VC1i6 e6i c a xir n cha Ch()111
p il tnr h6111 chorn dui, la noi bam ella day chang ch rn dui
D~u tren x o g (ttd co du true di,ie biet:
- LC1pvi", xu n d~e Cthan xiro g lC'1I (10n tan e6 kh/rp , ' Iphia tron
- Cac h0 xiro g tu lai C phan vo XL(!ng d,le ella c6 x ir o g dui va tv do ti0 n i
voi dL(l'1ng giap
th6 g niy co 1119teh6 y~u t le6 la 11(1id~ g~y, d~ bi tl',~ khop,
A Tr~t kh6'p hanq
Day la m9t (/ 111 thud g khcp thud g g;)p (' 1 n u i lcn d ll ehftn thud g, d 1119t
Il,fe l11~lIlh tile ll(lng gi{lIl ti~p vaa d§.u cit((Ii xL(d g dui V;l vung g6i khi (ll'l gftp,
Trang 1214 Chi Ky thu~ chyp X-quang Xll'Ol~:: kh_6p = c_h_i_du_,61_' _
Trang 13Bili 3 Khop hang 15
Hlnh 1-7. Ch up kh dp hang th ~ ng , B~n chan xo ay vao t rong mot qoc 15 - 20 ° (A ) tia tru n g tam
th ~ ng g o e vai phim(jdi~m giO'anep ben neu ehup mQtb e ( 8 )
Trang 1416 (II], Kythu~t ch~p X-quang xu'ong kho? chi duo;
-_ Chan d \l1chup du i th~ng, b:1I1chan x ay nhe vao tro g theo phuo g thttn
dirng mOt )!l\e kho;mg I" O _ 0 1l , Tir th~ nay giup e6 X Ul111 g d i t ir huo g ra
truoc duoc way thco hlr"!11t:Il r lJ11 ngang' song so g v Ji Ilhim,Chlnh hai gai
chau truoc trC:nso g SOil! \ " Ii rn(lt han, n~u benh nhiin hi g~y e 6 x o g dui
+ N~u chup hai khop lr~n (;ung mOt phim phai dung phim 3 x40 em, tia
trung tilm di v o g glll' "Cji phim ddi~m giG'a uudng n i di~m gifra hai
n~p bt;n,_ Thong s6 ch~p: 70 kV, ,~) mAs, 100 cm, co llcoi ehtmg md,
2 Ch~p khdp hang th5ng nfim sap (it up d~ng)
_ B~nh nhflll n1m s~p tl'011hill1clWp s o ch m~t phftn llrng so voi phL(C)n
tan ulillg mQt goc ' 11Iang _ ,_ Phim 18x24 em u~t trC:ll billl sao cho khdp hfmg vao gilra phim
_ Tia trung Him: ch~eh lSI) len phia d~u so vdi phuong th~n c1un tdi tren
di~m gi[ra mo g 5 cm " ; l l)phim,
_ Thong s{) ch~p: 70 kV, 4" mAs, tOOcm, colu(Ji l<)e,
DGi voi b~nh nhfll1 cLr uQn uLCI,k ' khd hang, co th~ chl;lP tu th~ ni~u d~lOho?c
- -40 ~~ feb CQn UOivC!i hl:Jlh nhan _khong cLr dOng UltllC khop hfll1g cCl th~
ch\lp tu'th~ tia X di ngan ILrtrong ra,
i 'I'll' th~ nieu <.lao(!-linh I-X)
_ B~nh nhiil1 nrlm eh0ch Il~!,u i v~ phia dm clWp vLJiIltng 1< , 1 voi m(ll ban
Trang 15rhco hiro g n m n ga n g so n ~()n \'d i phim.
Hmh 1-8 K y th ud l chup kh o p hang nghieng ur th e nieu 0(:10 , narn nghieng kho a ng 4 5 ° , tia
t r ung l a m th~ng gee(joi~m giO ' aben
Trang 16
18 C hI. Ky thu~t chl,lp X-quang xU'ong kh o'P~ -chi du'o;
lh:1I1ggee voi phim \ 1ui~m gi[(aoU0 gnC)i l1i~mgiC(ah i ncp b n
+ D6i vlj IL(lh c a ~ch1l19tben:
• Nhu I L( Ih tren Illl;il' chan kh6 g cfm chup JU(li \h~ g Ben din ch p
g lj) khop hang \ · i I-.h('jpg6i, r6i x ay (lui ra n gll il i khoang 45° s y { ji
plll((jng th mg dirng, h~tnchan d oc ap dua vao kll{jp g i ben o i die
oL(ng tci e6XU(jn lI ili ddi~m gilia n~pben
_ Th n s ri chup: 70 k V, ·1 m/vs, 100 C111 , ell l L( ( l Chl \ l g mil
Trang 17Bai 3 Kh6'p hang 19
J.T\ith~ tia X di ngang (it dung) (Hinh 1-1(l )
_ Ri;nh nhfin ll m nglta tre b n chup, chan dau d~ thea nr th~co n ng, ch~n
_ Phim 2 x:'() em, dl(.C ap sat vao h()lIg h ( '11 chup san ella khdp ha g V I O
giua phim
_ Tia trung Him: di ngang th a diro g It IOhl'ji h i m?l rh~ng dung doc giLril
TII\ X 01NGI\N(
Trang 1820 ChI Kythu~t ch~lpX-QuangxU ' Ollg khop chi du -'oi
-Hlnh 1-11 Giai phau phim chup khop hang th~ng.
khop, 6 Ba sau 7 Ba tnroc B.l) X-quang (qiot 1$X-quang) 9 La bit 10 Cham xudng duL 11 Ndi bam day ch~ng iron 12 c'6 giai phau , 13 MEIUchuy~n Ion 14 Mau chuy~n nho 15 c'6 phllU thu?t 16 BLiang lien rnau chuy~n.
Hlnh 1-12 Giai phau phim cbup khop hang nghieng.
1 Xu d ng mu 2 Xu ' dng chau , 3 XLidng ngoi 4 6 cOL5 Ba trLioc '6 cOi 6 Ba sau '6
cOi 7 Cham xudng dui U C6 giai phau, 9 Mau chuy 6 n lon , 10 Mau chuy~n nha.
11 C6 phau thu?t
Trang 19Khop g6i
' ' v - " ,.
mliG tj~u hgG t? P ,~' " -:"'::.:' 0;,,:, '" " , :' : '
Nh v~y khd glIi (h(c,le oi nhL(h i k dp I;li C ( II I eLta xl(ln dl , I11Qtdi¢n kh,''1)c i I CI
Trang 2022 (111.Ky th~~t chyp X-quang XU'011gkhop chi duo;
Ill' lI "- ) '111lI:1III !l1 1 u X[I V dinh c C, 1 n 111l(dlghay kh6 g Moi chin iluro g vung
nan ,
B Benh ly khop g6i
C Tran dich khop g6i
111.K V TI - H J AT CHl)P KHOP GOr
['hill!
Trang 21Hmh 1 - 13. Ky lh uM chup khop goi th~ng voi lin lrung tam th~ng qoc voi phim a bo d 'O i xu ' d ng
oann che (khe khop).
_ H~'nh nha ntm sftp tren ba xqu ng, c~ng ch n co len V~IciL(c;JrI)'L'( \ diuh
vil() g()i d~m sao ch true cua ci,ng chan 1 ~ 1 ()vCli m~lt han mot g6c \)-4 ( {
_ Phim 18x24 em dat dudi g5i, c1i0 chinh khc k Clp vao trung t[lm phim
ltlrl1 g , qu a v un g khe k (lp c1A(11( 1 , k' d(ll1h d~l1,vii V; I Otrung tam phim
_ Tlt ii ng s5chup: 50 kV 2 ll\ / S. I()O em, kho ]; lLCdich ng mo
Thlfd g ap dung ky ihuat chup khl'lp gl i nghien ng():li,
Trang 22? :I Chl :_~y' lhu~t chl;lP X-quang )(.U'Ol1g khiYp chi d~?'_i
-Tin trung tfllu: l'hiQu vuo 1I1(;11l)!khc khiJp d~1 (bnh u t lU sau )· in banh chc I
ern nhung e c-ch nhc v~phi.: d 1I 'i ll (VI 16i c~u tro g lh r ,p 1\1111lel d iungD~ ,nhu vay phim s~ eho 111nh2 IClci lLl xud g dui cho g len nl1au)
Thong 5 chup: )() kv, 25111/,100 em, kh n Il(lJie ClI1) 1111\
,hide Ihi c o th i; cl wp ur Ih & n il i c n uon g B " nh nh a n n t m n p ' r: J a l philTIphi "
uong va n ng C(lOdrill gClilen, lia irung t r im di ngan Ill'ngoiu Vi l
IV GIAI PHAU ONG DUNG PHIM CHI)P KHOP GOI
Trang 23Bai 4 Khop g6i 25
Hlnh 1-15 Giai ph a u phim chup khap go i th~ng.
1.Th a n xU'dngdui 2 XU'dngbanh cho 3 L 6i cau trang 4 Loi cau nqoai 5.Hanh
l en loi c u 6 Gai chay 7 Mam chay 8 Loi C Ll tru ' ac, 9 Than xU ' o'ngchay 10 Ba u tren XU D' ngmac 11.XU'o'ngmac 12 Khap chay mac 13 Khe khop
2
6
I
Hlnh 1-16 G i ai ph , ;u phim chup khcp goi nghien q.
1 XU 'd n du i 2 L icau trang 3 Loic u nqoa! 4 Ba tre l o i cau 5 X U ' o' n ba nh
che 6 M am ch a y 7 Gai chay 8 Loi c l o 9 XU ' o'ngmac 10 XU'dngchay