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<p><strong style="white-space: normal; max-width: 100%; color: rgb(68, 68, 68); font-family: 宋体; line-height: 28px; text-align: justify; word-wrap: break-word !important; box-sizing: border-box !important;"><img src="http://mmbiz.qpic.cn/mmbiz/cNuNdEZ2BK7eIOv9Picyop7PMgk4WxqGic2j5DxUL3wUSibm7NHtElM54LKicnibUXq4tOGwibRI4usKjpCZN6JKgQkQ/0" data-ratio="0.11857707509881422" data-w="" width="auto" src="http://mmbiz.qpic.cn/mmbiz/cNuNdEZ2BK7eIOv9Picyop7PMgk4WxqGic2j5DxUL3wUSibm7NHtElM54LKicnibUXq4tOGwibRI4usKjpCZN6JKgQkQ/0" style="word-wrap: break-word !important; box-sizing: border-box !important; width: auto !important; visibility: visible !important;" /></strong></p><p style=""><img src="http://mmbiz.qpic.cn/mmbiz/A1DicCH9Vl6NaLQSgFQhicLczUCPibhad5fuDRdVibrEudOjk631gshaqM0zWnvMJD02258ZU5EDFY0qZBjvzZSgibw/0" src="http://mmbiz.qpic.cn/mmbiz/A1DicCH9Vl6NaLQSgFQhicLczUCPibhad5fuDRdVibrEudOjk631gshaqM0zWnvMJD02258ZU5EDFY0qZBjvzZSgibw/0" style="float: none; word-wrap: break-word !important; box-sizing: border-box !important; visibility: visible !important; width: auto !important;" data-ratio="0.782608695652174" data-w="" /></p><p style=""><span style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important; font-family: 宋体;">随着科学技术和我国医疗卫生事业的高速发展，医用X线和CT机已在我国市、县级医院普及，高档多层螺旋CT也在省、市级重点医院陆续使用。球管是CT中最昂贵的消耗性核心部件，购价从十几万元到上百万元。扫描中（特别是曝光次数足够多的球管）常报有关球管故障，进行认真检查分析，对非致命性故障及时修理排除，恢复正常扫描，不但减少停机时间，保证好的社会效益，更能有效延长球管的使用寿命，创造好的经济效益。本文结合有关资料和自己在工作中的体会，浅谈有关球管的一些问题，希望能起到抛砖引玉作用。不妥之处希望各位专家和同行老师朋友给予指正。</span></p><p style=""><span style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important; font-family: 宋体;">1 球管的结构组成</span></p><p style=""><span style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important; font-family: 宋体;"> 一般CT球管由管芯、管套和相配的油循环冷却部分组成，其中管芯又有旋转阳极、灯丝、管芯玻壳等组成。</span></p><p style=""><span style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important; font-family: 宋体;">2 影响球管使用寿命的因素</span></p><p style=""><span style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important; font-family: 宋体;"> 影响CT管球使用寿命的因素主要有以下几个方面：</span></p><p style=""><span style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important; font-family: 宋体;">2．1 管球的安装调试</span></p><p style=""><span style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important; font-family: 宋体;"> 应该严格按着管球技术参数的要求对灯丝电压、电流等进行调整，作好前后位置、kV、mA等校准，定期检测各项参数并及时调整。否则，不但影响管球寿命，而且影响图象质量，甚至出现伪影。</span></p><p style=""><span style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important; font-family: 宋体;">2．2 扫描技术条件的设定</span></p><p style=""><span style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important; font-family: 宋体;"> 条件主要有：kV、mA、扫描时间（管球旋转一周所需时间）、层厚、螺距、扫描范围、重建方式等参数。</span></p><p style=""><span style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important; font-family: 宋体;">2．3 管球冷却系统的工作状态</span></p><p style=""><span style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important; font-family: 宋体;"> 大部分CT球管的冷却系统采用风冷却——油冷却——管球的方式，注意观察管球冷却系统的工作效率显得极为重要。最重要的工作就是定期清洁过滤网上的灰尘和散热器的尘土，使风的流速始终保持最佳状态，提高冷却效率。</span></p><p style=""><span style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important; font-family: 宋体;">2．4 管球本身质量问题</span></p><p style=""><span style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important; font-family: 宋体;"> 管球的合理使用主要体现为扫描热容量的控制，在不影响图象质量的情况下，根据扫描要求和实际人体扫描图象，适当减低MAS;螺旋扫描患者与轴位扫描患者搭配检查，根据不同部位调整螺距;定期检查管球供电参数及冷却系统工作状态。通过以上方法制定各台CT的工作常规要求操作人员严格执行。经过两年多的观察，管球的平均使用寿命有了很大幅度的提高。</span></p><p style=""><span style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important; font-family: 宋体;">3 CT球管的日常维护与保养</span></p><p style=""><span style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important; font-family: 宋体;">3．1 外部的三相电源检测。包括三相电源的相位、相辐平衡稳定，及相辐均衡，不移相及地线的阻值与接地良好与否。</span></p><p style=""><span style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important; font-family: 宋体;">3．2 消灭老鼠与蟑螂等动物。由于它们咬断电线，污染线路板，引起火灾现象屡见不鲜。</span></p><p style=""><span style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important; font-family: 宋体;">3．3 机房的温湿度。温度太高或太低，电子电路都不能正常工作。工作环境太干，容易引起静电；工作环境太湿，容易因氧化物灰尘等潮湿引起电路短路。通常工作环境温度维持20～300之间，温度变化率≤30C/h，湿度75%，湿度变化率在≤5%/h。</span></p><p style=""><span style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important; font-family: 宋体;">3．4 CT对球管的各种工作参数的检测，包括CT球管的kV、Ma、温度等。</span></p><p style=""><span style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important; font-family: 宋体;">3．5 高压电缆与球管的接触良好，接触零部件无杂质，每两年检查一次。</span></p><p style=""><span style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important; font-family: 宋体;">4 球管的常见故障及维修</span></p><p style=""><span style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important; font-family: 宋体;"> 针对球管及其高压引起的故障现象，按照组成我们粗略的归纳如下：</span></p><p style=""><span style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important; font-family: 宋体;">4．1 灯丝问题——一般灯丝开路或半开路</span></p><p style=""><span style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important; font-family: 宋体;"> 故障表现为：加高压后不曝光，无管电流或电流不稳定，提示灯丝开路（或Low mA），在查灯丝供电又正常的情况下，测量灯丝电阻开路多为球管灯丝开路。需要注意的是：有时灯丝处于半开路状态，时通时不通，工作时加热引起开路，而断电时冷却又连通，往往引起误判，需反复鉴别。</span></p><p style=""><span style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important; font-family: 宋体;">4．2 管芯真空度下降或管芯玻壳破损</span></p><p style=""><span style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important; font-family: 宋体;"> 故障表现为：查看故障代码一般提示过载报警。一种情况是管芯长期使用后灯丝蒸发，靶面受损气化，管芯真空度降低；二是球管长时间不使用，管芯有气体渗入，或芯壳老化开裂，有油渗入，高温炭化产生气体，管芯真空度下降。</span></p><p style=""><span style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important; font-family: 宋体;">4．3 旋转阳极不转</span></p><p style=""><span style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important; font-family: 宋体;"> 故障表现：报警显示旋转阳极（Rotor）故障。此故障一般有以下两种原因：一是旋转阳极定子线圈损坏（开路或短路）；二是旋转阳极转子卡死或轴承磨损后间隙过大，通电后分布磁场不均衡而吸死。</span></p><p style=""><span style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important; font-family: 宋体;">4．4 管套内高压打火</span></p><p style=""><span style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important; font-family: 宋体;"> 此类故障发生时，报警显示过载。高压电缆插头松动或与插座间的密封绝缘降低或高压插头开裂，均可引起间隙性打火，严重时出现过载报警而中断扫描，打火重建的图像中出现细条干扰线。拔出高压电缆插头检查，可发现插头、插座有明显的放电炭化灼痕，并伴刺激性气味。用无水酒精和纱布清理干净后，重新封好高压胶垫、高压硅酯或绝缘油后可恢复正常。</span></p><p style=""><span style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important; font-family: 宋体;">4．5 管芯内部打火</span></p><p style=""><span style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important; font-family: 宋体;"> 故障表现为：一启动曝光立即过载，提示过载（Over mA），一般发生于曝光计数较多的球管。有时降低kV、mA后尚可扫描，但图像差。管芯长期使用后灯丝蒸发，靶面受损气化，管芯真空度降低；或因玻壳在高温油压下有裂纹，管芯有气体渗入；或芯壳老化开裂，有油渗入，高温炭化产生气体，管芯真空度下降，球管报废。</span></p><p style=""><span style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important; font-family: 宋体;">4．6 管套漏油</span></p><p style=""><span style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important; font-family: 宋体;"> 轻微漏油时不影响工作，漏油较多后，管套内会有气泡，扫描时会出现过载（套内打火）。外观检查即可发现，仔细观察可找到漏油部位，多为管接头处松动或密封垫老化所致。拧紧接头或更换密封垫可恢复正常。</span></p><p style=""><span style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important; font-family: 宋体;">4．7 球管过热</span></p><p style=""><span style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important; font-family: 宋体;"> 故障表现为：扫描中等待冷却时间过长，提示温度或油压故障，多为球管油循环冷却系统故障。具体可分为：</span></p><p style=""><span style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important; font-family: 宋体;">4．7．1 散热器栅网被灰尘塞满，散热不良，清灰后正常。</span></p><p style=""><span style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important; font-family: 宋体;">4．7．2 冷却风扇不转，多为绕组损坏或轴承卡死。更换风扇。</span></p><p style=""><span style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important; font-family: 宋体;">4．7．3 循环油泵坏。油泵电机坏或轴承卡死或油泵损坏，修或更换。</span></p><p style=""><span style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important; font-family: 宋体;">4．7．4 油路过滤网阻塞。绝缘油内杂质过多或有异物，清洗换油可正常。</span></p><p style=""><span style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important; font-family: 宋体;">球管故障判断相关因素较多，如何区分清楚是否球管问题比较复杂，我们可细分为：</span></p><p style=""><span style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important; font-family: 宋体;"> （1）高压控制回路故障；（2）高压逆变（触发）故障；（3）阳极旋转控制器故障；（4）阳极逆变触发故障；（5）灯丝电路故障；（6）高压电缆击穿；（7）高压油箱内反馈电阻异常；（8）高压油箱内硅堆击穿等。</span></p><p style=""><span style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important; font-family: 宋体;"> 管球的合理使用主要体现为扫描热容量的控制，在不影响图象质量的情况下，根据扫描部位要求和实际人体扫描图象，适当减低mAS；定期检查管球供电参数及冷却系统工作状态，通过以上方法制定各台CT的工作常规要求操作人员严格执行，可使CT寿命有很大幅度的提高。</span></p><p style=""><img src="http://mmbiz.qpic.cn/mmbiz/rz7R73cuHRrv6jdOCoJeZmYwvEAIoHpY0a7yJL2egiaEokLTpwkIsIRTzTFUic09aEThKHS4hrEcSqU0lAS3tu5g/0" data-ratio="0.14784394250513347" data-w="487" width="auto" src="http://mmbiz.qpic.cn/mmbiz/rz7R73cuHRrv6jdOCoJeZmYwvEAIoHpY0a7yJL2egiaEokLTpwkIsIRTzTFUic09aEThKHS4hrEcSqU0lAS3tu5g/0" style="font-size: 15px; 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margin-bottom: 0px; max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; background-color: rgb(255, 255, 255); color: rgb(51, 51, 51); font-family: 宋体; font-size: 14px; line-height: 24px; orphans: 2; widows: 2; box-sizing: border-box !important;"><span style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important;"></span></p><p style="margin-top: 0px; margin-bottom: 0px; max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; background-color: rgb(255, 255, 255); color: rgb(51, 51, 51); font-family: 宋体; font-size: 14px; line-height: 24px; orphans: 2; widows: 2; box-sizing: border-box !important;"><span style="max-width: 100%; font-size: 19px; font-family: 仿宋; word-wrap: break-word !important; box-sizing: border-box !important;">群主微信号：</span><span style="max-width: 100%; font-size: 19px; font-family: 仿宋; color: rgb(255, 0, 0); background-color: rgb(84, 141, 212); word-wrap: break-word !important; box-sizing: border-box !important;"><strong style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important;">shanying916</strong></span></p><fieldset class="brcolor" style="white-space: normal; margin: 0px; padding: 5px; border: 1px solid rgb(0, 187, 236); max-width: 100%; color: rgb(62, 62, 62); font-family: 微软雅黑; line-height: 24px; font-size: 12px; background-color: rgb(248, 247, 245); word-wrap: break-word !important; box-sizing: border-box !important;"><legend style="padding: 0px; max-width: 100%; color: rgb(51, 51, 51); margin: 0px 10px; border-width: 0px; word-wrap: break-word !important; box-sizing: border-box !important;"><span class="bkcolor" style="max-width: 100%; margin: 0px; padding: 5px 10px; border: 0px; color: rgb(255, 255, 255); font-weight: bold; font-size: 14px; border-top-left-radius: 5px; border-top-right-radius: 5px; border-bottom-right-radius: 5px; border-bottom-left-radius: 5px; background-color: rgb(0, 187, 236); word-wrap: break-word !important; box-sizing: border-box !important;"><span style="max-width: 100%; margin: 0px; padding: 0px; border: 0px; word-wrap: break-word !important; box-sizing: border-box !important;">复制上面微信号</span><img data-s="300,640" data-ratio="1.35" data-w="20" src="http://mmbiz.qpic.cn/mmbiz/A1DicCH9Vl6NE8iaIXiblrE1WKyXQz6qbATAS0VZxTKlGupjMMNvicoNs9vhvYGBr83wmsdO1ouTw7kVDibk9w6VoMg/0" class="" id="c6" width="auto" width="auto" src="http://mmbiz.qpic.cn/mmbiz/A1DicCH9Vl6NE8iaIXiblrE1WKyXQz6qbATAS0VZxTKlGupjMMNvicoNs9vhvYGBr83wmsdO1ouTw7kVDibk9w6VoMg/640?tp=webp" style="margin: 0px; padding: 0px; border: 0px; word-wrap: break-word !important; box-sizing: border-box !important; visibility: visible !important; width: auto !important;" /><span style="max-width: 100%; margin: 0px; padding: 0px; border: 0px; word-wrap: break-word !important; box-sizing: border-box !important;">联系我哟</span></span></legend><blockquote style="padding: 0px; border: 0px; max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important;"><p style="margin-top: 0px; margin-bottom: 0px; max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; padding: 0px; border: 0px; box-sizing: border-box !important;"><span style="max-width: 100%; margin: 0px; padding: 0px; border: 0px; color: rgb(255, 192, 0); font-size: 14px; word-wrap: break-word !important; box-sizing: border-box !important;"></span><span style="max-width: 100%; color: rgb(255, 192, 0); margin: 0px; padding: 0px; border: 0px; font-size: 14px; word-wrap: break-word !important; box-sizing: border-box !important;">? </span><span style="max-width: 100%; color: rgb(127, 127, 127); margin: 0px; padding: 0px; border: 0px; line-height: 28px; word-wrap: break-word !important; box-sizing: border-box !important;">定期推送</span><span style="max-width: 100%; color: rgb(255, 192, 0); margin: 0px; padding: 0px; border: 0px; line-height: 28px; word-wrap: break-word !important; box-sizing: border-box !important;">医械资讯</span><span style="max-width: 100%; margin: 0px; padding: 0px; border: 0px; line-height: 28px; word-wrap: break-word !important; box-sizing: border-box !important;"><span style="max-width: 100%; margin: 0px; padding: 0px; border: 0px; word-wrap: break-word !important; box-sizing: border-box !important;"><span style="max-width: 100%; color: rgb(127, 127, 127); word-wrap: break-word !important; box-sizing: border-box !important;">，</span><span style="max-width: 100%; color: rgb(0, 176, 80); word-wrap: break-word !important; box-sizing: border-box !important;">厂家推介</span><span style="max-width: 100%; color: rgb(127, 127, 127); margin: 0px; padding: 0px; border: 0px; word-wrap: break-word !important; box-sizing: border-box !important;">，</span><span style="max-width: 100%; margin: 0px; padding: 0px; border: 0px; word-wrap: break-word !important; box-sizing: border-box !important;"><span style="max-width: 100%; color: rgb(112, 48, 160); word-wrap: break-word !important; box-sizing: border-box !important;">维修知识</span><span style="max-width: 100%; color: rgb(127, 127, 127); word-wrap: break-word !important; box-sizing: border-box !important;">，</span><span style="max-width: 100%; color: rgb(0, 176, 240); word-wrap: break-word !important; box-sizing: border-box !important;">产品知识</span><span style="max-width: 100%; color: rgb(127, 127, 127); word-wrap: break-word !important; box-sizing: border-box !important;">，</span><span style="max-width: 100%; color: rgb(146, 208, 80); word-wrap: break-word !important; box-sizing: border-box !important;">医疗器械相关</span></span></span><span style="max-width: 100%; color: rgb(127, 127, 127); word-wrap: break-word !important; box-sizing: border-box !important;">等诸多优质内容，</span><span style="max-width: 100%; color: rgb(127, 127, 127); margin: 0px; padding: 0px; border: 0px; word-wrap: break-word !important; box-sizing: border-box !important;">最接地气</span><span style="max-width: 100%; color: rgb(127, 127, 127); word-wrap: break-word !important; box-sizing: border-box !important;">、</span><span style="max-width: 100%; color: rgb(127, 127, 127); margin: 0px; padding: 0px; border: 0px; word-wrap: break-word !important; box-sizing: border-box !important;">重价值</span><span style="max-width: 100%; color: rgb(127, 127, 127); word-wrap: break-word !important; box-sizing: border-box !important;">的医疗器械微信平台！关注我们妥妥没错，推广合作联系我呦！</span></span></p></blockquote></fieldset><p style="white-space: normal;"><img data-s="300,640" src="http://mmbiz.qpic.cn/mmbiz/A1DicCH9Vl6MYAEPWTib8tjxcvx0icbN5kq6PvfS6PHyKaMRwicKyXRpyaPRoHgn3OOr1vBKYm6b9vtYp87hJM8nXw/0" data-ratio="0.7835365853658537" data-w="328" /></p>
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发表于 2020-10-21 13:51:12