| 摘要: |
| 目的对髋臼骨折ABC分类系统进行可信度评价。方法于已行手术治疗的1 122例髋臼骨折患者的病例资料库中按ABC分类系统3个亚型中每种亚型随机抽取20例,再分为2组: 平片组30例(提供骨盆正位、髂骨斜位、闭孔斜位X线片)及平片+CT组30例(提供X线片、二维CT)。抽取1~5年资、5~10年资、10~15年资各3位骨科专业医生,对平片组和平片+CT组影像资料进行读片并根据ABC分类系统做出诊断；每位观察者只读片而不知晓其他临床资料。于第1次读片(第1阶段)3个月后将相同的病例资料打乱顺序,再次请原3组人员进行读片(第2阶段)。对两次的结果进行统计分析,计算Kappa值进行一致性检验,以评估观察者间的可信度和可重复性。结果不同观察者间在第1和第2两个阶段的一致性分别为: 平片组0.66、0.71,平片+CT组0.67、0.72；同一观察者前后两次读片可重复性分别为: 平片组0.75,平片+CT组0.78；高年资组医生诊断的可信度和可重复性相对较高。结论以ABC分类系统对髋臼骨折进行分类诊断时,可以获得一致度较高的诊断结果；CT虽然对于髋臼骨折的治疗具有重大的指导意义,但并不能明显提高对髋臼骨折分类诊断的可信度。 |
| 关键词: 髋臼骨折 分类法 可信度 |
| DOI：10.3724/SP.J.1008.2012.00510 |
| 投稿时间：2011-12-03修订日期：2012-03-08 |
| 基金项目: |
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| Credibility assessment of ABC Classification for acetabular fractures |
| LIU Xin-wei1,WEI Xian-zhao1,WANG Zhi-wei1*,SHI Peng-fei2,SU Jia-can1,ZHANG Chun-cai1 |
(1. Department of Orthopaedics, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
2. Department of Air Duty, Lanzhou General Hospital, PLA Lanzhou Military Area Command, Lanzhou 730050, Gansu, China
*Corresponding author.) |
| Abstract: |
| ObjectiveTo assess the credibility of the ABC Classification for acetatbular fractures. MethodsThe data of 60 patients were randomly chosen from a total of 1 122 patients with acetabular fractures, who were classified according to ABC Classification, with each subtype including 20 cases. The 60 cases were divided into two groups: X-ray (Pelvis AP, oblique position of iliac bone and oblique position of obturator foramen radiographs without CT) and X-ray+CT (plain radiographs with 2D-CT). Nine surgeons, including 3 with 1-5 years’ experience, 3 with 5-10 years’ experience and 3 with 10-15 years’ experience, were asked to make diagnosis for the two groups using ABC Classification system. Each surgeon read the radiographs twice at a 3-month interval without knowledge of other clinical data. The order of the radiographs was changed in the second review. The results of the two sessions were analyzed and the inter- and intra-observer reliability and reproducibility were evaluated using Kappa test. ResultsThe inter-observer reliability during the two sessions were 0.66 (0.71) in X-ray group and 0.67 (0.72) in X-ray+CT group. Intra-observer reproducibility during the two sessions were 0.75 in group X-ray and 0.78 in X-ray+CT group. The diagnoses of surgeons with longer experience had higher credibility and reproducibility. ConclusionABC Classification can obtain high reliability diagnosis for acetabular fractures. CT is valuable for treatment of acetabular fracture, but it can not greatly increase the credibility of ABC Classification. |
| Key words: acetabular fracture classification reliability |
