中华创伤骨科杂志
中華創傷骨科雜誌
중화창상골과잡지
CHINESE JOURNAL OF ORTHOPAEDIC TRAUMA
2011年
2期
106-109
,共4页
马君%贾连顺%邵将%周许辉%宋滇文%朱巍%官正茂%黄俊俊
馬君%賈連順%邵將%週許輝%宋滇文%硃巍%官正茂%黃俊俊
마군%가련순%소장%주허휘%송전문%주외%관정무%황준준
颈椎%外伤%可重复性结果
頸椎%外傷%可重複性結果
경추%외상%가중복성결과
Cervical vertebrae%Trauma%Reproducibility of results
目的 评价脊柱创伤研究小组(STSG)提出的下颈椎损伤分型(SLIC)临床应用的可靠性和有效性。方法 选取2006年6月至2009年6月收治的30例下颈椎外伤患者，其中男24例，女6例；年龄31 ～74岁，平均54.4岁。损伤节段：C3/42例，C4/56例，C5/67例，C6/74例，C3-53例，C4-66例，C3-62例。30例患者中8例行非手术治疗，22例行手术治疗。根据SLIC系统进行评分，该系统主要以损伤形态、椎间盘韧带复合体(DLC)的完整性及神经功能状态3个成分为基础。使用组间相关系数(ICC)评价SLIC临床应用的可靠性，使用Cohen's Kappa评价SLIC指导治疗的有效性。结果 损伤形态观察者间信度优(ICC =0.68)，DLC完整性观察者间信度良好(ICC =0.51)，神经功能状态观察者间信度特优(ICC=0.83)，SLIC总得分观察者间信度优(ICC=0.78)。SLIC推荐治疗方案和实际治疗方案达到86.7％的一致性(Kappa =0.706)。若排除得分3～5分的患者，SLIC推荐治疗方案和实际治疗方案达到92.9％的一致性(Kappa =0.837)。结论 SLIC简单、标准、可靠性强，能有效地指导临床治疗。
目的 評價脊柱創傷研究小組(STSG)提齣的下頸椎損傷分型(SLIC)臨床應用的可靠性和有效性。方法 選取2006年6月至2009年6月收治的30例下頸椎外傷患者，其中男24例，女6例；年齡31 ～74歲，平均54.4歲。損傷節段：C3/42例，C4/56例，C5/67例，C6/74例，C3-53例，C4-66例，C3-62例。30例患者中8例行非手術治療，22例行手術治療。根據SLIC繫統進行評分，該繫統主要以損傷形態、椎間盤韌帶複閤體(DLC)的完整性及神經功能狀態3箇成分為基礎。使用組間相關繫數(ICC)評價SLIC臨床應用的可靠性，使用Cohen's Kappa評價SLIC指導治療的有效性。結果 損傷形態觀察者間信度優(ICC =0.68)，DLC完整性觀察者間信度良好(ICC =0.51)，神經功能狀態觀察者間信度特優(ICC=0.83)，SLIC總得分觀察者間信度優(ICC=0.78)。SLIC推薦治療方案和實際治療方案達到86.7％的一緻性(Kappa =0.706)。若排除得分3～5分的患者，SLIC推薦治療方案和實際治療方案達到92.9％的一緻性(Kappa =0.837)。結論 SLIC簡單、標準、可靠性彊，能有效地指導臨床治療。
목적 평개척주창상연구소조(STSG)제출적하경추손상분형(SLIC)림상응용적가고성화유효성。방법 선취2006년6월지2009년6월수치적30례하경추외상환자，기중남24례，녀6례；년령31 ～74세，평균54.4세。손상절단：C3/42례，C4/56례，C5/67례，C6/74례，C3-53례，C4-66례，C3-62례。30례환자중8례행비수술치료，22례행수술치료。근거SLIC계통진행평분，해계통주요이손상형태、추간반인대복합체(DLC)적완정성급신경공능상태3개성분위기출。사용조간상관계수(ICC)평개SLIC림상응용적가고성，사용Cohen's Kappa평개SLIC지도치료적유효성。결과 손상형태관찰자간신도우(ICC =0.68)，DLC완정성관찰자간신도량호(ICC =0.51)，신경공능상태관찰자간신도특우(ICC=0.83)，SLIC총득분관찰자간신도우(ICC=0.78)。SLIC추천치료방안화실제치료방안체도86.7％적일치성(Kappa =0.706)。약배제득분3～5분적환자，SLIC추천치료방안화실제치료방안체도92.9％적일치성(Kappa =0.837)。결론 SLIC간단、표준、가고성강，능유효지지도림상치료。
Objective To evaluate the clinical reliability and validity of the sub-axial injury classification(SLIC) system proposed by the Spine Trauma Study Group(STSG) in 2007.Methods Thirty cases of cervical injury were randomly chosen from the patients treated in our department from June 2006 to June 2009. Eight spine surgeons scored them according to the SLIC system respectively. Interclass correlation coefficient (ICC) was used to assess the reliability of SLIC, and Cohen's Kappa was employed to evaluate its validity.ResultsGood inter-observer agreement was demonstrated in injury morphology (ICC =0. 68),and moderate inter-observer agreement in disco-ligamentous complex (DLC) (ICC = 0. 51 ). The inter-observer evaluation of neurologic status proved to be the most reliable with an ICC of 0. 83, and the inter-observer agreement in total SLIC score was excellent with an ICC of 0. 78. The SLIC score algorithms agreed with the actual treatments in 86.7％ of cases (Kappa =0. 706). The agreement rose to 92.9％ (Kappa =0. 837), if the cases for which a definitive recommendation was not made (average SLIC score, 3 to 5) were excluded.Conclusion SLIC is a simple, reliable, and effective adjunct in clinical decision-making for the treatment of lower cervical spine injuries.
