本文選題：脊柱骨折　切入點：分型　出處：《新疆醫(yī)科大學》2017年碩士論文　論文類型：學位論文

【摘要】：目的:評價新的胸腰椎骨折AO分型系統(tǒng)可信度和可重復性,并探討影響分型一致性的主要原因。方法:隨機抽取5名脊柱外科醫(yī)師利用新的胸腰椎骨折損傷AO分型系統(tǒng)獨分別獨立對收治的70例胸腰椎損傷患者的胸腰椎正側位X線片、CT、MRI及臨床病史資料進行分型。5名醫(yī)師在一次分型中只要有一名醫(yī)師分型不同即認定為不一致。6周后,打亂病例資料順序并再次進行分型。70例患者的全部資料均不含與分型有關的任何標記,通過計算平均百分比確定分型一致率,應用加權Cohen′s Kapp系數(shù)評價觀察者間可信度和觀察者內(nèi)可重復性。結果:新的胸腰椎骨折損傷AO分型系統(tǒng)完整分型可信度平均Kappa系數(shù)為0.602,可重復性平均Kappa系數(shù)為0.782。其中在3大骨折類型中壓縮型(A型)和分離移位型(C型)損傷的判定具有中、高度的可信度和極好的可重復性,可信度平均Kappa系數(shù)分別為0.604、0.662,可重復性平均Kappa系數(shù)分別為0.787、0.761;牽張型損傷(B型)判定的一致性相對較差,可信度平均為0.362,可重復性平均Kappa系數(shù)為0.657。損傷各亞型具有中、高度的一致性,可信度平均Kappa系數(shù)為0.526,可重復性平均Kappa系數(shù)為0.701。其中B2型一致性最差,可信度平均Kappa系數(shù)為0.214,可重復性平均Kappa系數(shù)為0.633,其次為A4型,可信度平均Kappa系數(shù)為0.322,可重復性平均Kappa系數(shù)為0.685。結論:新型胸腰椎骨折損傷AO分型系統(tǒng)具有中、高度的一致性和極好的可重復性。對判定A4和B2型骨折的不確定性是影響分型一致性主要原因。
[Abstract]:Objective: to evaluate the reliability and repeatability of AO classification system for thoracolumbar fractures. Methods: using the new AO classification system for thoracolumbar fracture injury, 70 patients with thoracolumbar spine injury were treated separately. MRI and clinical history data of lateral radiographs. In a single classification, only one physician was found to be inconsistent in 6 weeks after the classification was different. Disturbing the sequence of cases and reclassifying. All the data of 70 patients did not contain any marks related to the classification, and the consistent rate of classification was determined by calculating the average percentage. The weighted Cohen's Kapp coefficient was used to evaluate the inter-observer reliability and intra-observer repeatability. Results: the average reliability Kappa coefficient and repeatability average Kappa coefficient of the new AO classification system for thoracolumbar fracture injury were 0.602 and 0.782, respectively. Among the three major fracture types, the compression type A) and the separated displacement type C) were found to have moderate injuries. The mean reliability and repeatability were 0.6040.662and 0.7870.761.The consistency of the determination of distraction injury type B) was relatively poor, and the mean reliability and repeatability were 0.6040.662and 0.7870.761respectively. The average reliability is 0.362, the average repeatability Kappa coefficient is 0.657.The average reliability Kappa coefficient is 0.526, and the repeatability average Kappa coefficient is 0.701.The type B2 has the worst consistency. The average Kappa coefficient of reliability is 0.214, the average Kappa coefficient of repeatability is 0.633, the second is A4 type, the average Kappa coefficient of credibility is 0.322, the average Kappa coefficient of repeatability is 0.685.Conclusion: the AO classification system for thoracolumbar fracture injury is moderate. High consistency and excellent reproducibility. Uncertainty in judging A _ 4 and B _ 2 fractures is the main factor affecting classification consistency.
【學位授予單位】：新疆醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R683

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相關期刊論文 前2條

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2 孫天勝;張志成;;胸腰椎損傷分類及損傷程度評分系統(tǒng)的評估及初步應用[J];脊柱外科雜志;2007年06期

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本文編號：1646898