拉梅拉骨扩展性粘液 (LOEM) 系统:用于内镜外科手术的新分类和试点研究
Serafin Sanchez-Gomez1,2,3, Daniel Martin-Jimenez1,4,2, Ramon Moreno-Luna5,6,7
1Rhinology Unit, Department of Otolaryngology, Head and Neck Surgery, Virgen Macarena University Hospital, Dr Fedriani Av. 3, 41009, Seville, Spain.
概括
拉梅拉骨扩展性粘膜 (LOEM) 系统为慢性鼻炎 (CRS) 中的内镜外科手术 (ESS) 提供了标准化的分类. 该系统实现了高专家一致,改善了手术技术描述和结果的可比性.
科学领域:
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
- 手术分类系统是手术分类系统.
- 医疗信息学 医疗信息学
背景情况:
- 慢性鼻炎 (CRS) 的管理通常涉及内镜鼻手术 (ESS).
- 目前对ESS技术的描述缺乏标准化,这阻碍了结果的比较.
- 需要一个一致的系统来分类ESS中的手术程度和粘膜管理.
研究的目的:
- 引入Lamella Ostium Extent Mucosa (LOEM) 系统,这是ESS的一个新型分类.
- 在ESS中对CRS进行手术骨延伸和粘膜管理的描述进行标准化.
- 提高CRS研究中手术结果的可比性.
主要方法:
- LOEM系统使用字母代码 (L,O,E,M) 来表示地形外科细节.
- 七名鼻科医生使用双轮德尔菲方法评估了11例CRS外科病例.
- 评估者之间的可靠性是使用Cohen的kappa进行评估的,使用一个基于Web的应用程序来开发可用性.
主要成果:
- 在第一个Delphi轮中,获得了实质性的整体专家协议 (κ=0.77),在澄清后增加到 κ=0.81.
- 在"Mucosal方法" (M) 项目中,最初的公平协议 (κ=0.37) 呈现出改善,改进后为 κ=0.79.
- 试验复试分析显示几乎完全一致 (κ=0.82),表明可靠性很高.
结论:
- LOEM系统为ESS提供了一个紧而全面的代码,整合了解剖学和功能方面.
- 这种分类有助于外科医生沟通,并为CRS研究收集可靠的标记数据.
- 在未来的CRS研究中,LOEM系统具有标准化和验证手术方法的潜力.
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