论文部分内容阅读
目的:应用0期诊断标准调查新兵应力性骨折早期发生情况,评价其诊断效能,为应力性骨折早期预防提供依据。方法:选择驻豫某部新兵70例,在新兵训练第4周末由1名骨科主治医师与1名队医按照《军事训练伤所致应力性骨折0期诊断标准》进行检查,以磁共振成像(MRI)为金标准,对体检结果进行真实性和可靠性分析。结果:MRI检查显示应力性骨折17例(占24.3%);应力性骨折0期诊断标准的敏感度、特异性、准确度、阳性预告值、阴性预告值、阳性拟然比、阴性拟然比、约登指数、ROC曲线下的面积(AUC)分别是0.941、0.887、0.900、0.727、0.979、8.33、0.067、0.828、0.914,McNemar检验结果为P=0.125,吻合系数(Kappa值)K=0.753,P=0.000;骨科主治医师、基层医师0期诊断的符合率为0.900、相关系数K=0.771。结论:应力性骨折在新兵训练中发病率较高;0期诊断方法用于新兵训练期间应力性骨折的诊断真实性与可靠性较高,适合在基层部队推广。
OBJECTIVE: To investigate the early occurrence of stress fractures and evaluate its diagnostic efficacy by using the diagnostic criteria of stage 0 to provide the basis for early prevention of stress fractures. Methods: Seventy recruits were recruited from a department in Yuyi. At the end of the fourth week of recruiting training, one orthopedist physician and one team doctor examined them according to the diagnostic criteria of stage 0 of stress fracture caused by military training injury. The magnetic resonance imaging MRI) as the gold standard, the physical examination results were authenticity and reliability analysis. Results: MRI examination showed 17 cases of stress fracture (24.3%). The sensitivity, specificity, accuracy, positive predictive value, negative predictive value, positive predictive value, negative predictive value , Youden index and area under the ROC curve (AUC) were 0.941,0.887,0.900,0.727,0.979,8.33,0.067,0.828,0.914, McNemar test was P = 0.125, Kappa value was 0.753 , P = 0.000. The coincidence rate of 0th diagnosis between orthopedic physicians and primary physicians was 0.900, and the correlation coefficient K = 0.771. Conclusions: The incidence of stress fractures is higher in recruits training. The diagnostic method of stage 0 is more accurate and reliable in the diagnosis of stress fracture during recruits training, which is suitable for the promotion of grassroots units.