摘要
目的探究基于CT的Rasmussen放射学评分和解剖学参数预测胫骨平台骨折内固定术疗效的效能。方法回顾性分析2020年2月~2022年8月在我院就诊的200例行胫骨平台骨折内固定术患者临床资料,根据术后6个月疗效分为优良组(n=169)、非优良组(n=31)。比较两组基线资料、基于CT Rasmussen放射学评分、胫骨平台外侧后倾角、膝关节间隙宽度、内翻角、平台塌陷、股胫角,以Spearman分析CT检查结果与疗效相关性;以多因素Logistic回归分析基于CT的Rasmussen放射学评分和解剖学参数对疗效的影响;受试者工作特征曲线(ROC)分析基于CT的Rasmussen放射学评分和解剖学参数及其联合预测胫骨平台骨折内固定术疗效的效能。结果优良组半月板损伤患者占比低于非优良组(P<0.05);优良组Rasmussen放射学评分高于非优良组,后倾角、膝关节间隙宽度、内翻角、平台塌陷低于非优良组(P<0.05);相关性分析显示,Rasmussen放射学评分与疗效呈正相关(r=0.703),后倾角(r=-0.659)、膝关节间隙宽度(r=-0.621)、内翻角(r=-0.731)、平台塌陷(r=-0.617)与疗效呈负相关(均P<0.05);Logistic回归分析显示,校正了半月板损伤后,Rasmussen放射学评分、后倾角、膝关节间隙宽度、内翻角、平台塌陷仍是疗效的独立相关影响因素(均P<0.05);Rasmussen放射学评分、后倾角、膝关节间隙宽度、内翻角、平台塌陷预测疗效的ROC下面积(AUC)分别为0.779、0.818、0.757、0.815、0.809(均P<0.05),其中后倾角的AUC最大;Rasmussen放射学评分联合解剖学参数预测疗效的ROC曲线显示,其AUC为0.904(95%CI:0.854~0.941),大于后倾角(Z=0.395,P<0.05),预测敏感度为87.10%,特异度为86.98%。结论Rasmussen放射学评分、后倾角、膝关节间隙宽度、内翻角、平台塌陷是胫骨平台骨折内固定术疗效的独立相关影响因素,基于CT联合检测以上参数或可作为胫骨平台骨折内固定术疗效的一个预测方案,为术�
Objective Exploring the efficacy of CT based Rasmussen radiological scoring and anatomical parameters in predicting the efficacy of internal fixation surgery for tibial plateau fractures.Methods Clinical data of 200 patients with internal fixation of tibial plateau fracture treated in our hospital from February 2020 to August 2022 were retrospectively analyzed,and they were divided into excellent group(n=169)and non-excellent group(n=31)according to the curative effect 6 months after operation.Baseline data of the two groups were compared based on CT Rasmussen radiology score,lateral posterior inclination Angle of tibial plateau,knee space width,varus Angle,platform collapse,femoro-tibial Angle,and the correlation between CT results and efficacy was analyzed by Spearman.Multivariate Logistic regression was used to analyze the effects of Ct-based Rasmussen radiological score and anatomical parameters on the therapeutic effect.Receiver Operating characteristic curve(ROC)analysis of Ct-based Rasmussen radiological scores and anatomical parameters and their combined efficacy in predicting the outcome of internal fixation of tibial plateau fractures.Results The proportion of patients with meniscus injury in excellent group was lower than that in non-excellent group(P<0.05).The Rasmussen radiological score of the excellent group was higher than that of the non-excellent group,and the posterior inclination Angle,knee space width,varus Angle and platform collapse were lower than those of the non-excellent group(P<0.05).Correlation analysis showed that Rasmussen radiology score was positively correlated with the curative effect(r=0.703),while the posterior inclination Angle(r=-0.659),knee space width(r=-0.621),varus Angle(r=-0.731)and platform collapse(r=-0.617)were negatively correlated with the curative effect(all P<0.05).Logistic regression analysis showed that after correcting for meniscus injury,Rasmussen radiological score,posterior inclination Angle,knee space width,varus Angle and platform collapse were still inde
作者
汪兆文
张翠娥
孙佳丽
李杰
霍玉宝
Wang Zhao-wen;Zhang Cui-e;Sun Jia-li;Li Jie;Huo Yu-bao(Department of Traumatology,The Fourth People's Hospital of Hengshui,Hengshui 053000,Hebei Province,China)
出处
《中国CT和MRI杂志》
2024年第7期172-175,共4页
Chinese Journal of CT and MRI
基金
衡水市科技局项目编号(2022014016Z)。
