面神经分级2.0对周围性面神经麻痹的评价研究  

Agreement between House-Brackmann Grading System and Facial Nerve Grading System 2.0 in Patients with Facial Nerve Paralysis

作　　者：李阳[1] 冯国栋[2] 田旭[2] 薛玉斌[2] 赵阳[2] 吴海燕[2] 高志强[2] 

机构地区：[1]西安交通大学第二附属医院耳鼻咽喉头颈外科病院,西安710004 [2]中国医学科学院北京协和医学院北京协和医院耳鼻咽喉科,北京100005

出　　处：《中华耳科学杂志》2014年第3期361-366,共6页Chinese Journal of Otology

基　　金：国家十二五科技支撑计划(2012BAI12B01)

摘　　要：目的比较House-brackmann分级(HBGS)和面神经分级2.0(FNGS 2.0)对周围性面神经麻痹的评价效果。方法 3名高年资医师和3名低年资医师分别使用HBGS和FNGS2.0分级方法,对50项周围性面神经麻痹患者的表情视频进行评价。对两种分级方法的重复性、一致性进行分析、比较。结果使用HBGS,低年资医生之间的评价一致性为39.5%,kappa值为0.30,高年资医生之间的评价一致性为56.5%,kappa值为0.43,两组之间具有显著性差异(p<0.05);使用FNGS2.0,低年资医生间的评价一致性为62.0%,平均ICC值为0.763,高年资医师之间的评价一致性为62.8%,平均ICC值为0.785,两组之间均没有显著性差异(P>0.05);HBGS和FNGS2.0的总体相关性ICC值为0.760,SCC值为0.746,kappa值为0.42;FNGS2.0与口的相关性为71%。结论 HBGS与FNGS2.0中度相关;使用HBGS,评判者间的一致性受医生的经验水平影响很大,而使用FNGS2.0,评判者重复性和一致性较好,与评判者的经验无关,与口的运动有较强的相关性。Objectives To analysis the correlation between House-brackmann Grading System （HBGS）and Facial Nerve Grading System2.0 （FNGS2.0） in evaluation of facial nerve paralysis. Methods Fifty video-recorded facial palsy pa-tients were graded by 3 residents and 3 experts using HBGS and FNGS2.0. Results Agreement percentage between residents for HBGS was 39.5%, and generalized kappa indicated only fair agreement（k=0.30）;Agreement percentage between experts for HBGS was 56.5%, and generalized kappa indicated moderate agreement（k=0.43）;The difference between the observer groups was statistically significant （P〈0.05）;.Agreement percentage between residents for FNGS2.0 was 62%, and average ICC indicated excellent agreement（ICC=0.763）;Agreement percentage between experts for HBGS was 62.8%, and average ICC indicated excel-lent agreement（ICC=0.785）;The difference between the observer groups was not statistically significant （P〉0.05）;The overall intra-class correlation coefficient （ICC） was 0.760,the Spearman correlation coefficient （SCC） was 0.746 and kappa coefficient was 0.42 （P〈0.05）;The exact agreements between regional assessment and FNGS 2.0 , were highest for the mouth （71%）. Conclusions FNGS 2.0 shows moderate agreement with HBGS. For HBGS the interobserver agreement was influnced by the doctor’s experi-ence;For FNGS2.0, the intraobserver and interobserver agreement was high, with no relation to doctor’s experience.

关 键 词：面神经麻痹 评价方法 House-brackmann分级 面神经分级2.0 

分 类 号：R745.12[医药卫生—神经病学与精神病学] Q429.7[医药卫生—临床医学]