退变性腰椎滑脱French分型和CARDS分型的可重复性与可信度研究

发布时间：2018-04-01 15:18

本文选题：退变性滑脱　切入点：French分型　出处：《中国脊柱脊髓杂志》2017年03期

【摘要】：目的 :对退变性腰椎滑脱的French分型及CARDS分型进行可重复性与可信度的对比分析,探讨两种分型在退变性腰椎滑脱患者中的应用价值。方法:回顾性分析2012年1月~2016年6月期间118例腰椎退变性滑脱(L4/5 91例、L5/S1 27例)患者,其中男性26例,女性92例,平均年龄61.1±8.1岁。3名脊柱外科医师对患者术前X线片独自进行两次测量,分别使用French分型和临床与影像学分型(clinical and radiographic degenerative spondylolisthesis,CARDS分型)进行评估和分型,收集结果 ,作同一观察者间可重复性及不同观察者间可信度分析。应用Kappa值比较分析两种分型的差异性。结果:3位观察者使用French分型系统共进行708次(118例×3×2次)分型,包括1型261次,2型107次,3型83次,4型54次,5型203次,观察者内分型一致率80.5%~86.4%(Kappa值0.740~0.815),属于"基本可信";观察者间分型一致率为79.7%~82.2%(Kappa值0.728~0.758),属于"基本可信"。测量并分型单个患者平均花费时间约138s。CARDS分型系统共708次分型中,包括A型(A1)19次,B型(B1 90次,B2 59次)149次,C型(C1 291次,C2 108次)399次,D型(D1 98次,D2 43次)141次,观察者内总体一致率90.7%~93.2%(Kappa值0.878~0.911),属于"完全可信";观察者间总体一致率88.1%~94.1%(Kappa值0.844~0.921),属于"完全可信"。测量并分型单个患者平均花费时间约67s。结论 :两种分型系统具有较高的可重复性与可信度,CARDS分型可信度与可重复性优于French分型。
[Abstract]:Objective: to compare the reproducibility and reliability of French and CARDS typing in degenerative lumbar spondylolisthesis. Methods: 118 cases of lumbar degenerative spondylolisthesis from January 2012 to June 2016 were analyzed retrospectively, including 26 males and 92 females. The mean age of spinal surgeons was 61.1 卤8.1 years old. The patients were assessed and classified by French classification, clinical and radiographic degenerative spondylolisthesis-cards classification, and the results were collected. The repeatability of the same observer and the reliability of different observers were analyzed. The differences between the two types were compared by using the Kappa value. Results 708 times (118 cases 脳 3 脳 2 times) were classified by using the French typing system. Including type 1, 261 times, type 2, type 107, type 3, type 3, type 83, type 4, type 54, type 5, type 5, 203, The concordance rate of intraobserver typing was 0.740 / 0.815g, which was "basically credible", and the consistency rate of inter-observer typing was 0.728 / 0.758g, belonging to "basic trustworthiness". The average time taken to measure and type a single patient was about 708 138s.CARDS typing system. Including A / A / A / A / A / A / B / B / B / B / B / B / B / B / B / B / B / B / B / B / B / B / B / B / B and B / B / B / B / B / B / B and B / B / B / B / B / B / B / B / B / B / B / B. The 90.7%~93.2%(Kappa value of the intra-observer population was 0.878 / 0.911, which was "completely credible", while the 88.1%~94.1%(Kappa value of the inter-observer population consistency rate was 0.844 ~ 0.921, which belonged to "completely credible". The average time taken to measure and classify a single patient was about 67 s. Conclusion: the two genotyping systems have a higher average time than that of the other two genotyping systems. High reproducibility and reliability are better than French typing in terms of reliability and repeatability of cards typing.
【作者单位】：南京大学医学院附属南京鼓楼医院集团宿迁市人民医院骨科;南京大学医学院附属南京鼓楼医院脊柱外科;
【基金】：南京市临床医学中心资助项目
【分类号】：R681.5

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