中国组织工程研究

中国组织工程研究 ›› 2012, Vol. 16 ›› Issue (48): 9109-9113.doi: 10.3969/j.issn.2095-4344.2012.48.034

• 骨与关节临床实践 clinical practice of the bone and joint • 上一篇    下一篇

下颈椎损伤分类评分系统的信效度检验及临床应用

耿大伟1，王黎明1，2，王大林2，徐 杰2，金成哲2，徐 燕2   

  1. 1南京医科大学第三临床医学院，江苏省南京市 210029
    2南京医科大学附属南京医院(南京市第一医院)，江苏省南京市 210029
  • 收稿日期:2012-03-12 修回日期:2012-04-22 出版日期:2012-11-25 发布日期:2012-11-25
  • 通讯作者: 王黎明，硕士，主任医师，教授，博士生导师，南京医科大学第三临床医学院，江苏省南京市 210029 Limingwang2000@yahoo.com
  • 作者简介:耿大伟★，男，1983年生，江苏省盐城市人，汉族，南京医科大学在读硕士，医师，主要从事关节外科和脊柱外科方面的研究。 gengdawei_2008@163.com

Reliability and validity evaluation and clinical application of sub-axial injury classification scoring system

Geng Da-wei1, Wang Li-ming1, 2, Wang Da-lin2, Xu Jie2, Jin Cheng-zhe2, Xu Yan2   

  1. 1Third Clinical Medical College of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
    2Affliated Nanjing Hospital of Nanjing Medical University (Nanjing First Hospital), Nanjing 210029, Jiangsu Province, China
  • Received:2012-03-12 Revised:2012-04-22 Online:2012-11-25 Published:2012-11-25
  • Contact: Wang Li-ming, Master, Chief physician, Professor, Doctoral supervisor, Third Clinical Medical College of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China; Affliated Nanjing Hospital of Nanjing Medical University (Nanjing First Hospital), Nanjing 210029, Jiangsu Province, China Limingwang2000@yahoo.com
  • About author:Geng Da-wei★, Studying for master’s degree, Physician, Third Clinical Medical College of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China gengdawei_2008@163.com

PDF

458

被引次数

7

摘要：

背景：脊柱损伤分类系统对下颈椎损伤的诊治及预后具有重要指导意义，然而临床上缺乏一种能被广泛接受的分类系统。
目的：对下颈椎损伤分类评分系统进行可信度分析与有效度检验，并观察其在临床治疗中的应用效果。
方法：基于下颈椎损伤分类评分系统治疗75例下颈椎损伤患者，根据该系统评分，11例<4分的患者选择非手术治疗，6例=4分及58例>4分的患者选择手术治疗，手术患者依据该系统中损伤形态学不同结合间盘韧带复合体损伤和神经损伤状态选择不同的手术入路。分别采用Cronbach’s α系数与Kappa系数考察内部一致性信度和重测信度；用内容效度指数检验内容效度。
结果与结论：下颈椎损伤分类评分系统亚类的内部一致性信度均在0.8以上，表明该评分系统具有较好的内部一致性信度。间盘韧带复合体及下颈椎损伤分类评分系统总分的重测信度为中度可信，形态学损伤、神经损伤状态及治疗选择的重测信度均大于0.6为高度可信。下颈椎损伤分类评分系统全部条目平均内容效度指数值为0.936，证明该评分系统各条目较好地指导了下颈椎损伤患者的诊断及治疗。根据该评分系统指导治疗75例下颈椎损伤患者，治疗后无神经损伤加重，并发症发生率较低，ASIA分级得到相应改善。提示下颈椎损伤分类评分系统具有较高的信效度，且应用简便、易于掌握，其在指导下颈椎损伤手术与非手术治疗以及手术入路的选择方面具有重要意义。

关键词: 下颈椎损伤, 分类评分系统, 信度, 效度, 治疗

Abstract:

BACKGROUND: Spine injury classification system has an important guiding sense to diagnosis, treatment and prognosis of sub-axial cervical spine injury, but it lacks a widely accepted classification system clinically.
OBJECTIVE: To evaluate the reliability and validity of the sub-axial injury classification system and to explore its role in the clinical application.
METHODS: Seventy-five patients with lower cervical spine injury were treated based on the sub-axial injury classification system. The 11 cases of less than 4 points received conservative treatment, according to fracture morphology, disco-ligamentous complex status and neurologic status, six cases of 4 points and 58 cases of more than 4 points received surgical treatment through different approach. Cronbach’s α coefficient and Kappa coefficient were used respectively to investigate internal consistency reliability and retest reliability, index of content validity was used to inspect content validity.
RESULTS AND CONCLUSION: The internal consistency reliability of sub-axial injury classification system was greater than 0.8, it indicated that the system had a high reliability. The retest reliability of disco-ligamentous complex and sub-axial injury classification system was moderately credible, the retest reliability of Kappa coefficients of morphology, neurologic status and proposed management were greater than 0.6. Average value of content validity index was 0.936, which proved that all entries of sub-axial injury classification system could guide the diagnosis and treatment of lower cervical injury nicely. Seventy-five patients with lower cervical spine injury were treated by the system with low incidence of complications
and there was no aggravation of neurological status, and the ASIA grade was improved. Sub-axial injury classification system has the advantages of high reliability and validity, simple use and easy master, and plays an important role in guiding the surgical decision and surgical approach.

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