动态喉镜诊断声带息肉价值评价.docVIP

动态喉镜诊断声带息肉价值评价 作者：吴国英 阿布都如苏力 尤乐都斯。 作者单位：1新疆医科大学, 2新疆维吾尔自治区人民医院耳鼻喉二科, 新疆乌鲁木齐 【关键词】 动态喉镜 诊断 声带息肉 价值评价 Evaluation of videostrosboscopy in the clinical diagnosis of vocal cord polyps WU GuoYing, Abudurusuli, Youlidusi Xinjiang Medical University, Urumqi 830011, China Abstract: Objective: To evaluate the efficacy of strobolaryngoscopy in the clinical diagnosis of vocal cord polyps. Methods: Patients suffering from vocal cord polyps and other voice disorders underwent strobolaryngoscopy. The videos and the examination process were replayed and 3 experienced largngologists judged according to the defined diagnostic standard, being blind of pathological results. Their judgments were contrasted with the pathological results. Results: 　Sensitivity of strobolaryngoscopy in the diagnosis of vocal cold polyps was 96.67%, specificity was 66.67%，and Youdens index was 63%, the positive likelihood ratio was 2.66，and negative likelihood ratio was 0.55, the pretest odds was 2.73, the posttest odds was 7.26, and the posttest probability was 87.89%, the agreement was 87.8%, adjusted agreement was 83.92%, observed agreement was 87.8%, agreement of chance was 64.13%, and actual agreement beyond chance was 23.67%, and Kappa was 0.63. Conclusion: Sensitivity and specificity of strobolaryngoscopy in the diagnosis of early vocal cold polyps are advanced. So strobolaryngoscopy is effectual for the clinical diagnosis of vocal cold polyps. Key words: vocal cord polyps; strobolaryngoscopy; sensitivity; specificity 声带息肉是临床上最常见的一种引起声音嘶哑的良性的声带增生性嗓音病。它是一种对患者生命威胁较小的嗓音疾病，未引起医生和患者足够的重视。但随着人们生活水平的提高，人们更加关注生活质量，声带息肉的患病率在喉科疾病中也逐渐增高［1］，越来越受到耳鼻喉科医生的关注。目前在临床上最常见的辅助诊断工具有间接喉镜、纤维喉镜、电子喉镜、动态喉镜。除动态喉镜外其他检查可以作为嗓音疾病的基本检查，但不能观察到声带快速振动的慢像，无法进一步了解声带振动的状况。动态喉镜又名喉闪光镜、喉动态镜或频闪观测器。是一种用来观察声带振动的电子仪器。其特点是采用频闪光源，通过喉镜看到缓慢运动的或静止的声带视觉假象［2］。动态喉镜的最大优点是利用物理学原理通过频闪光源代替平光使高速振动的声带变为肉眼可见的慢速运动，从而使我们能观察到声带黏膜上的微细病变［3］，而且是一种无创、无损伤、痛苦小的检查手段。本研究通过动态喉镜检查手段诊断声带增生性病变，以探讨动态喉镜对声带息肉的诊断价值，从而提高声带息肉的临床诊断准确性。 1资料与方法 1.1临床资料选取2008 年1～9月