新的胸腰椎骨折AO分型系统可信度和可重复性研究

发布时间：2018-03-22 03:33

本文选题：脊柱骨折　切入点：分型　出处：《新疆医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:评价新的胸腰椎骨折AO分型系统可信度和可重复性,并探讨影响分型一致性的主要原因。方法:随机抽取5名脊柱外科医师利用新的胸腰椎骨折损伤AO分型系统独分别独立对收治的70例胸腰椎损伤患者的胸腰椎正侧位X线片、CT、MRI及临床病史资料进行分型。5名医师在一次分型中只要有一名医师分型不同即认定为不一致。6周后,打乱病例资料顺序并再次进行分型。70例患者的全部资料均不含与分型有关的任何标记,通过计算平均百分比确定分型一致率,应用加权Cohen′s Kapp系数评价观察者间可信度和观察者内可重复性。结果:新的胸腰椎骨折损伤AO分型系统完整分型可信度平均Kappa系数为0.602,可重复性平均Kappa系数为0.782。其中在3大骨折类型中压缩型(A型)和分离移位型(C型)损伤的判定具有中、高度的可信度和极好的可重复性,可信度平均Kappa系数分别为0.604、0.662,可重复性平均Kappa系数分别为0.787、0.761;牵张型损伤(B型)判定的一致性相对较差,可信度平均为0.362,可重复性平均Kappa系数为0.657。损伤各亚型具有中、高度的一致性,可信度平均Kappa系数为0.526,可重复性平均Kappa系数为0.701。其中B2型一致性最差,可信度平均Kappa系数为0.214,可重复性平均Kappa系数为0.633,其次为A4型,可信度平均Kappa系数为0.322,可重复性平均Kappa系数为0.685。结论:新型胸腰椎骨折损伤AO分型系统具有中、高度的一致性和极好的可重复性。对判定A4和B2型骨折的不确定性是影响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.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R683

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