CAJ | 학술논문

目的评价Cobb法测量先天性脊柱侧凸角度的可靠性和可重复性.方法选取第四军医大学西京医院脊柱外科2010年1月-2013年12月收治的78例先天性脊柱侧凸患者的标准前后位全脊柱X线片.由5名医生利用Digimizer软件对全脊柱X线片测量Cobb角度,每人测量2次,2次测量间隔3周.记录测量的Cobb角度以及两次测量的差值.应用组内相关系数(ICC)判定可靠性和可重复性.结果 Cobb法测量先天性脊柱侧凸角度的可信度范围为0.84 ～ 0.98,5名测量者两次测量间最大差值的范围为20°～57°,其中差值＞10°的例数范围为13～ 46例,同一测量者两次测量间的误差约8.5°;测量者之间的可信度为0.947,5名测量者在81°～ 110°组和＞110°组之间的ICC为0.623和0.822.结论 Cobb法测量先天性脊柱侧凸可以获得较好的可靠性和可重复性,但是测量者内部以及测量者之间仍然出现较多且较大的误差,尤其在侧凸角度较大时,Cobb法测量先天性脊柱侧凸的准确性缺乏稳定性.
목적 평개Cobb법측량선천성척주측철각도적가고성화가중복성.방법 선취제사군의대학서경의원척주외과2010년1월-2013년12월수치적78례선천성척주측철환자적표준전후위전척주X선편.유5명의생이용Digimizer연건대전척주X선편측량Cobb각도,매인측량2차,2차측량간격3주.기록측량적Cobb각도이급량차측량적차치.응용조내상관계수(ICC)판정가고성화가중복성.결과 Cobb법측량선천성척주측철각도적가신도범위위0.84 ～ 0.98,5명측량자량차측량간최대차치적범위위20°～57°,기중차치＞10°적례수범위위13～ 46례,동일측량자량차측량간적오차약8.5°;측량자지간적가신도위0.947,5명측량자재81°～ 110°조화＞110°조지간적ICC위0.623화0.822.결론 Cobb법측량선천성척주측철가이획득교호적가고성화가중복성,단시측량자내부이급측량자지간잉연출현교다차교대적오차,우기재측철각도교대시,Cobb법측량선천성척주측철적준학성결핍은정성.
Objective To analyze the reliability of measurement of Cobb angle of the patients with congenital scoliosis.Methods Seventy-eight standard standing posteroanterior whole-spine radiographs of the patients with congenital scoliosis treated in Xijing hospital of Fourth Military Medical University from January 2010 to December 2013 were reviewed.Five doctors measured the Cobb angle twice by Digimizer software,with an interval of at least three weeks between the two measurements.The results of the Cobb angle and deviations between the two measurements were recorded.Both intraobserver and interobserver agreements were assessed with the intraclass correlation coefficient (ICC).Results All ICC values representing intraobserver variability of observers ranged from 0.84 to 0.98.The biggest intraobserver indifference ranged from 20° to 57°,and there were 13 to 46 curves of which intraobserver indifference was more than 10° between five observers.The intraobserver variance was 8.5°.The ICC values representing intrerobserver variability of observers was 0.947.Interobserver ICC values in 81 °-110° and ＞ 110° groups were 0.623 and 0.822,respectively.Conclusions Applying Cobb method as a measurement tool to evaluate the congenital scoliosis is reliable in term of intra-and interobserver variability.But there still exists big difference between intra-and interobserver,especially for severe scoliosis,the accuracy of Cobb method deserves questionable.