本文選題：面神經(jīng)功能　切入點(diǎn)：House　出處：《中南大學(xué)》2014年博士論文　論文類型：學(xué)位論文

【摘要】：目的 本研究通過分析與比較House Brackmann分級(jí)法(HBGS)與Facial nerve grading system2.0(FNGS2.0)在聽神經(jīng)瘤術(shù)后面神經(jīng)功能分級(jí)方面的一致性與優(yōu)劣。探討更加適合聽神經(jīng)瘤手術(shù)后面神經(jīng)功能評(píng)價(jià)的分級(jí)方法。 方法 面神經(jīng)功能評(píng)價(jià)的對(duì)象為2012年12月至2013年12月就診我院的28位聽神經(jīng)瘤患者。評(píng)價(jià)材料選擇視頻資料；使用相機(jī)錄像記錄病人一系列的動(dòng)作包括抬眉、閉眼、示齒、鼓腮、吹哨以及大笑等；將FNGS2.0的英文評(píng)價(jià)方法進(jìn)行中文翻譯,制定中文版評(píng)價(jià)表；10名評(píng)價(jià)者觀看視頻后分別用兩種方法對(duì)全部患者的面部運(yùn)動(dòng)視頻資料進(jìn)行打分,結(jié)果匯總后使用SPSS軟件整理并分析數(shù)據(jù)；評(píng)價(jià)指標(biāo)包括HBGS與FNGS2.0相關(guān)性分析、觀察者間一致性,以及信度、敏感度等。 結(jié)果 兩種方法評(píng)價(jià)了28位患者的面部視頻,共記錄560個(gè)數(shù)據(jù)。使用HBGS得出的打分結(jié)果為Ⅰ級(jí)45例,Ⅱ級(jí)67例,Ⅲ級(jí)104例,Ⅳ級(jí)56例,V級(jí)8例,無Ⅵ級(jí)。FNGS2.0得出的結(jié)果為Ⅰ級(jí)34例,Ⅱ級(jí)62例,Ⅲ級(jí)112例,Ⅳ級(jí)71例,V級(jí)1例,無Ⅵ級(jí)。打分者用兩種方法打出結(jié)果相同的分?jǐn)?shù)共有178對(duì),合計(jì)356例,占總體的63.57%。 FNGS2.0與HBGS的相關(guān)性系數(shù)r達(dá)到均值0.802；觀察者間一致性相關(guān)系數(shù)HB分級(jí)為從0.578到0.923(平均0.744),FNGS2.0的范圍是從0.791到0.943(平均為0.866)；HB分級(jí)的基于平均值的組內(nèi)相關(guān)系數(shù)是0.968,而FNGS2.0的是0.986。兩種評(píng)價(jià)方法的評(píng)價(jià)者信度均較好；準(zhǔn)確一致性比例HBGS為64.62%,FNGS2.0為76.36%。異常值比例HBGS為35.7%,FNGS2.0為0%。在FNGS2.0區(qū)域評(píng)價(jià)的評(píng)估中,各個(gè)區(qū)域的觀察者間一致性依次為：眉區(qū)0.711到0.966(平均0.819)；眼區(qū)0.725到1.000(平均為0.845)；鼻唇溝區(qū)0.516到1.000(平均0.829)；嘴角區(qū)0.557到0.962(平均0.800)；聯(lián)帶運(yùn)動(dòng)0.510到0.932(平均0.731)。 結(jié)論 在聽神經(jīng)瘤術(shù)后患者面神經(jīng)功能評(píng)價(jià)中,FNGS2.0與HBGS的信度和敏感度均較好,兩種方法都是優(yōu)秀的面神經(jīng)功能評(píng)價(jià)方法。FNGS2.0與HBGS的相關(guān)性較強(qiáng),能夠保證評(píng)價(jià)結(jié)果在樣本及數(shù)據(jù)庫中的延續(xù)性。同時(shí),FNGS2.0能有效減少了觀察者間偏倚,在準(zhǔn)確一致性比例和異常值控制方面均優(yōu)于HBGS。此外,FNGS2.0中增加的面部細(xì)節(jié)的評(píng)價(jià),能夠有效區(qū)分細(xì)微的面部特征改變,因此綜合上述,FNGS2.0在聽神經(jīng)瘤術(shù)后患者面神經(jīng)評(píng)價(jià)中有較為廣闊的應(yīng)用前景。
[Abstract]:Purpose. In this study, the consistency and advantages of House Brackmann classification and Facial nerve grading system 2.0 FNGS 2.0 in the classification of facial nerve function after acoustic neuroma were analyzed and compared. Method. The subjects of facial nerve function evaluation were 28 patients with acoustic neuroma who were admitted to our hospital from December 2012 to December 2013. The materials were used to select video data. A series of movements including raising eyebrow, closing eyes, showing teeth and gills were recorded by camera. FNGS2.0 's English evaluation method was translated into Chinese, and 10 reviewers watched the video and scored all patients' facial motion video data in two ways after watching the video. Results the data were collected and analyzed by SPSS software, and the evaluation indexes included HBGS and FNGS2.0 correlation analysis, inter-observer consistency, reliability, sensitivity and so on. Results. Two methods were used to evaluate the facial video of 28 patients, and a total of 560data were recorded. The results obtained by HBGS were 45 cases of grade 鈪，

本文編號(hào)：1582530