面神经评价系统FNGS 2.0在听神经瘤术后病人面神经功能分级中的应用

发布时间：2018-03-08 05:12

  本文选题：面神经功能　切入点：House　出处：《中南大学》2014年博士论文　论文类型：学位论文

【摘要】：目的 本研究通过分析与比较House Brackmann分级法(HBGS)与Facial nerve grading system2.0(FNGS2.0)在听神经瘤术后面神经功能分级方面的一致性与优劣。探讨更加适合听神经瘤手术后面神经功能评价的分级方法。 方法 面神经功能评价的对象为2012年12月至2013年12月就诊我院的28位听神经瘤患者。评价材料选择视频资料；使用相机录像记录病人一系列的动作包括抬眉、闭眼、示齿、鼓腮、吹哨以及大笑等；将FNGS2.0的英文评价方法进行中文翻译,制定中文版评价表；10名评价者观看视频后分别用两种方法对全部患者的面部运动视频资料进行打分,结果汇总后使用SPSS软件整理并分析数据；评价指标包括HBGS与FNGS2.0相关性分析、观察者间一致性,以及信度、敏感度等。 结果 两种方法评价了28位患者的面部视频,共记录560个数据。使用HBGS得出的打分结果为Ⅰ级45例,Ⅱ级67例,Ⅲ级104例,Ⅳ级56例,V级8例,无Ⅵ级。FNGS2.0得出的结果为Ⅰ级34例,Ⅱ级62例,Ⅲ级112例,Ⅳ级71例,V级1例,无Ⅵ级。打分者用两种方法打出结果相同的分数共有178对,合计356例,占总体的63.57%。 FNGS2.0与HBGS的相关性系数r达到均值0.802；观察者间一致性相关系数HB分级为从0.578到0.923(平均0.744),FNGS2.0的范围是从0.791到0.943(平均为0.866)；HB分级的基于平均值的组内相关系数是0.968,而FNGS2.0的是0.986。两种评价方法的评价者信度均较好；准确一致性比例HBGS为64.62%,FNGS2.0为76.36%。异常值比例HBGS为35.7%,FNGS2.0为0%。在FNGS2.0区域评价的评估中,各个区域的观察者间一致性依次为：眉区0.711到0.966(平均0.819)；眼区0.725到1.000(平均为0.845)；鼻唇沟区0.516到1.000(平均0.829)；嘴角区0.557到0.962(平均0.800)；联带运动0.510到0.932(平均0.731)。 结论 在听神经瘤术后患者面神经功能评价中,FNGS2.0与HBGS的信度和敏感度均较好,两种方法都是优秀的面神经功能评价方法。FNGS2.0与HBGS的相关性较强,能够保证评价结果在样本及数据库中的延续性。同时,FNGS2.0能有效减少了观察者间偏倚,在准确一致性比例和异常值控制方面均优于HBGS。此外,FNGS2.0中增加的面部细节的评价,能够有效区分细微的面部特征改变,因此综合上述,FNGS2.0在听神经瘤术后患者面神经评价中有较为广阔的应用前景。
[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，

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