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

目的:评价动态喉镜临床诊断声带息肉的准确性。方法:采用双盲法,按照诊断标准,对患者动态喉镜检查录像进行诊断,诊断结果与活检病理结果相对照。应用临床流行病学诊断试验的公式计算灵敏度、特异度、漏诊率、误诊率、正确诊断指数及阳性似然比等。结果:动态喉镜诊断声带息肉的灵敏度为96.67%,漏诊率3.33%,特异度66.67%,误诊率33.33%,阳性似然比2.90,阴性似然比0.05,阳性预测值89.23%,阴性预测值87.5%,验前比2.52,验后比7.3,验后概率87.96%,符合率88.89%,调整一致率85.02%,观察一致性88.89%,机遇一致性64.56%,实际一致性24.33%,Kappa(值)0.63。结论:动态喉镜诊断声带息肉有较高的灵敏度和特异度,有利于提高声带息肉临床诊断的准确性。

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 strobo-laryngoscopy. 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 Youden＇s index was 63%, the positive likeli-hood 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 strobolaryngoseopy is effectual for the clinical diagnosis of vocal cold polyps.