CAJ | 학술논문

目的探讨临床评价唇腭裂五码数字分类的实用性.方法选择经过两课时唇腭裂五码数字分类培训的14名年轻医师,对200例未经治疗的唇腭裂患者照片进行分类诊断.诊断标准:以唇龈沟和切牙乳头(切牙孔)为标志将裂隙可能涉及的部位依次分为以下解剖部位:右(左)上唇、右(左)上颌牙槽突及原发腭、继发腭.每个解剖部位的裂隙程度分5个级别:0级:无裂隙；1级:隐裂；2级:裂隙＜ 1/2解剖部位；3级:裂隙＞1/2解剖部位；4级:完全性裂.以指导教师的诊断编码为依据,统计14名年轻医师的诊断总体符合率、各解剖部位裂隙程度诊断符合率,并统计裂隙部位类型.结果诊断总体符合率88％ (2475/2800).按裂隙部位及裂隙程度,4级唇裂和4级牙槽突裂诊断符合率较高,为99％(707/714)和100％(546/546),而2、3级的牙槽裂诊断符合率为70％(98/140)和82％(103/126).在五码数字分类的17种裂隙部位类型中,本组病例中出现了14种类型.结论唇腭裂五码数字分类简明易懂,但当裂隙延伸至分级界线时可能出现判断偏差,需要进一步培训或优化裂隙程度分级.
목적 탐토림상평개진악렬오마수자분류적실용성.방법 선택경과량과시진악렬오마수자분류배훈적14명년경의사,대200례미경치료적진악렬환자조편진행분류진단.진단표준:이진간구화절아유두(절아공)위표지장렬극가능섭급적부위의차분위이하해부부위:우(좌)상진、우(좌)상합아조돌급원발악、계발악.매개해부부위적렬극정도분5개급별:0급:무렬극；1급:은렬；2급:렬극＜ 1/2해부부위；3급:렬극＞1/2해부부위；4급:완전성렬.이지도교사적진단편마위의거,통계14명년경의사적진단총체부합솔、각해부부위렬극정도진단부합솔,병통계렬극부위류형.결과 진단총체부합솔88％ (2475/2800).안렬극부위급렬극정도,4급진렬화4급아조돌렬진단부합솔교고,위99％(707/714)화100％(546/546),이2、3급적아조렬진단부합솔위70％(98/140)화82％(103/126).재오마수자분류적17충렬극부위류형중,본조병례중출현료14충류형.결론 진악렬오마수자분류간명역동,단당렬극연신지분급계선시가능출현판단편차,수요진일보배훈혹우화렬극정도분급.
Objective To evaluate the five-digit numerical recording system (LAPAL system) for classification of cleft lip and palate.Methods Fourteen young doctors took part in the study after receiving one-hour instruction twice for the LAPAL system.Photographs of 200 cases of untreated cleft lip and palate were used for the evaluation.The diagnostic codes of the patient were recorded and compared with the teacher's standard diagnosis.The basic criterion of the LAPAL system was that the clefts were arranged in five anatomical components in order of right lip (L),right alveolus and primary palate (A),secondary palate (P),left alveolus and primary palate (A),and left lip (L).The degrees of the cleft severity were recorded with Arabic number 0 for the intact,1 for the subcutaneous or submucous cleft,2 for clefts smaller than half of a component,3 for clefts larger than half of a component,4 for complete clefts.Results The rate of the diagnostic coincidence was 88％ (2475/2800) totally.The higher coincidence appeared in degree 4 of cleft lip and in degree 4 of cleft alveolar and cleft primary palate as 99％ (707/714) and 100％ (546/546),respectively.The lower coincidence appeared in degree 2 and degree 3 of clefts of the alveolus and primary palate as 70％ (98/140) and 82％ (103/126),respectively.Among the 17 types of possible cleft combination,14 types were found in the present study.Conclusions The LAPAL system is easily understood and grasped in a short time.Clefts on the border of adjoin degrees may cause confusion in diagnosis.More training or simplified modification is suggested.