脊柱肿瘤不稳定SINS评分系统的可行性和可重复性研究  

Study of Reliability and Reproducibility of SINS Classification System for Spinal Tumor

作　　者：马俊明[1] 尹萌辰[1] 莫文[1] 陈妮[1] 薛瑞瑞[1] 马传风 童正一[1] 夏烨[1] 俞志兴[1] 

机构地区：[1]上海中医药大学附属龙华医院骨伤科,上海200030

出　　处：《中国中医骨伤科杂志》2016年第9期18-21,共4页Chinese Journal of Traditional Medical Traumatology & Orthopedics

基　　金：上海市自然科学基金项目(13ZR1442100);上海市高级中西医结合人才培养项目(ZY3-RCPY-4-2034)

摘　　要：目的:分析SINS评分系统在观察者间的可信度和观察者内的可重复性,评价其临床运用价值。方法:选取5名具有一定临床经验的脊柱外科医生,并对这5名脊柱外科医生进行脊柱肿瘤不稳定SINS评分系统的培训。使用SINS评分系统对30例患者进行评分。3个月后进行重复分析。对于SINS评分系统中的分类项目采用多因素Fless’s k系数进行一致性检验,评价者间和评价者内的研究结果采用Cohen’s k系数进行一致性检验。结果:可信度检验k为0.866,其中受累节段及疼痛的一致性为"极佳",脊柱力线情况、椎体塌陷情况、后外侧结构受累程度的一致性均为"中度",骨损伤类型的一致性最差,为"低度"。可重复性检验k为0.906,其中受累节段及疼痛的一致性为"极佳",脊柱力线情况、椎体塌陷情况、后外侧结构受累程度的一致性均为"高度",骨损伤类型的一致性为"中度"。结论:SINS评分系统具有较好的可信度及可重复性,在临床上可推广使用,并且在脊柱肿瘤的治疗决策制定上具有较大的意义。Objective：To evaluate the reliability and reproducibility of SINS scoring system and explore its clinical application value.Methods：All 30 patients were enrolled.Five spine surgeons who have certain clinical experience were selected.For SINS scoring system classification,we use Flesss kvalue to check the coefficient consistency for multi-factor.We use Cohens kvalue to check the coefficient consistency among evaluators and evaluator＇s results.After 3months,we repeated the analysis.Results：The reliability credibility test kvalue is 0.866.The location and pain were＂excellent＂.The radiographic spinal alignment and vertebral body collapse,the posterolateral involvement of spinal elements were＂moderate＂,and the bone lesion was＂light＂.Reproducibility credibility test kvalue is 0.906.The location and pain were＂excellent＂.The radiographic spinal alignment and vertebral body collapse,the posterolateral involvement of spinal elementsare were＂highly＂,and the bone lesion was＂light＂.Conclusions：SINS scoring system is reliable and reproducible,which can be promoted in clinical use.It is of high significance on the treatment of spinal tumor decision-making.

关 键 词：脊柱不稳定评分系统 可信度 可重复性 

分 类 号：R738.1[医药卫生—肿瘤]