Alborz University Medical Journal
نشریه علمی پژوهشی دانشگاه علوم پزشکی البرز
aumj
Medical Sciences
http://aums.abzums.ac.ir
1
admin
2322-3839
2588-3046
10.61186/aums
fa
jalali
1399
10
1
gregorian
2021
1
1
10
1
online
1
fulltext
fa
بررسی میزان توافق تفسیرسیتیاسکن بیماران با ترومای ستون مهرههای گردنی بین رزیدنتهای طب اورژانس و گزارش رادیولوژیستها در بیمارستان شهدای هفت تیر
A Study on the Agreement Rate of CT-Scan Interpretation of the Cervical Spine Trauma Patients Between the Reports of Emergency Medicine Residents and Radiologist in "Shohadaye 7Tir Hospital"
تخصصي
Special
پژوهشي
Research
<strong><span style="font-family:B Lotus;"><span style="font-size:10.0pt;">هدف:</span></span></strong> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">بررسی</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">حاضر</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">با</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">هدف</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">تبیین</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">میزان</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">توافق</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">تفسیر</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">سیتیاسکن</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">گردن</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">بیماران</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">ترومایی</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">در</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">دو</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">گروه</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">طب</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">اورژانس</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">و</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">رادیولوژی بیمارستان</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">شهدای</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">هفتم</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">تیر</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">تهران</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">انجام</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">شد</span></span><span dir="LTR"><span style="font-size:9.0pt;">.</span></span><span style="font-family:B Lotus;"><span style="font-size:10.0pt;"> </span></span><br>
<strong><span style="font-family:B Lotus;"><span style="font-size:10.0pt;">مواد</span></span></strong> <strong><span style="font-family:B Lotus;"><span style="font-size:10.0pt;">و</span></span></strong> <strong><span style="font-family:B Lotus;"><span style="font-size:10.0pt;">روشها: </span></span></strong><span style="font-family:B Lotus;"><span style="font-size:10.0pt;">این</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">مطالعه</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">تحلیلی</span></span><span dir="LTR"><span style="font-size:9.0pt;"> - </span></span><span style="font-family:B Lotus;"><span style="font-size:10.0pt;">مقطعی</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">در</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">بیمارستان</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">شهدای</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">هفتم</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">تیر</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">در</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">شهر</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">تهران</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">انجام</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">گرفت. تفسیر</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">408<br>
سیتیاسکن</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">مربوط به بیماران</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;"> باترومای</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">گردن</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">که</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">توسط</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">گروه</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">طب</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">اورژانس</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">و</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">رادیولوژی</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">در</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">شش ماهه</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">دوم</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">سال</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">1396</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">ثبت</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">شده</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">بود،</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">با یکدیگر مقایسه شد. یافتهها با</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">کمک</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">نرم</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">افزار </span></span><span dir="LTR"><span style="font-size:9.0pt;">SPSS</span></span><span style="font-family:B Lotus;"><span style="font-size:10.0pt;"> نسخه</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">23</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">با</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">استفاده</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">از</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">روشهای</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">آماری</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">توصیفی تجزیه</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">و</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">تحلیل</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">شد.</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">برای</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">مشخص</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">کردن</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">میزان</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">توافق</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">تفسیرهای</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">سیتیاسکن</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">گردن</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">از</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">ضریب</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">کاپا </span></span><span dir="LTR"><span style="font-size:9.0pt;">(kappa)</span></span><span style="font-family:B Lotus;"><span style="font-size:10.0pt;"> استفاده</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">شد.</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;"></span></span><br>
<strong><span style="font-family:B Lotus;"><span style="font-size:10.0pt;">یافتهها: </span></span></strong><span style="font-family:B Lotus;"><span style="font-size:10.0pt;">میانگین سنی بیماران مراجعه کننده با ترومای گردن 72/8 </span></span><span style="font-family:Cambria,serif;"><span style="font-size:10.0pt;">±</span></span><span style="font-family:B Lotus;"><span style="font-size:10.0pt;"> 47/32 سال<span style="font-weight:normal;"><span style="font-family:B Lotus;"> بود و </span></span></span></span><span style="font-family:B Lotus;"><span style="font-size:10.0pt;">69 نفر زن (17%) و 339 نفر مرد (83%) بودند. در</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">296</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">سیتیاسکن</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">تفسیر</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">گروه</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">طب</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">اورژانس</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">و</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">رادیولوژی یکسان</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">بود</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">که</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">این</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">تعداد</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">شامل 55/72 % موارد میشود و در 112 مورد تشخیصها مطابقت نداشت که برابر 45/27 % بود.</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">در</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">آنالیز</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">تحلیلی</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">ضریب</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">کاپا</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">برای مطابقت تشخیصها 612/0 به دست</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">آمد </span></span><span style="font-family:B Lotus;"><span style="font-size:10.0pt;">(</span></span><span style="font-family:B Lotus;"><span style="font-size:10.0pt;">001/0 </span></span><span dir="LTR"><span style="font-size:9.0pt;">P <</span></span><span style="font-family:B Lotus;"><span style="font-size:10.0pt;">)</span></span><span dir="LTR"><span style="font-size:9.0pt;">.</span></span><span dir="LTR"><span style="font-size:9.0pt;"></span></span><br>
<strong><span style="font-family:B Lotus;"><span style="font-size:10.0pt;">نتیجهگیری: </span></span></strong><span style="font-family:B Lotus;"><span style="font-size:10.0pt;">با</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">وجود</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">عمر</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">جوان</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">رشته</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">طب</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">اورژانس</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">در</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">کشور</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">ما،</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">پزشکان</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">این</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">رشته</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">توانسته</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">اند</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">با</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">آموختن</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">دانش</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">های</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">مرتبط</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">با اورژانس</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">از</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">جمله</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">رادیولوژی</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">توانمندی</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">های</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">خود</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">را</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">افزایش</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">دهند</span></span><span dir="LTR"><span style="font-size:9.0pt;"> . </span></span><span style="font-family:B Lotus;"><span style="font-size:10.0pt;">تفاوتهای</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">موجود در</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">دو</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">گروه،</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">آموزش</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">پایه</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">و</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">اصولی</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">تر</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">مفاهیم</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">رادیولوژی</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">در</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">رشته</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">طب</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">اورژانس</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">را</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">گوشزد میکند. برای</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">این</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">منظور</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">میتوان</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">از</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">پزشکان</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">مجرب</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">موجود</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">در</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">هیأت</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">علمی</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">طب</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">اورژانس</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">یا</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">رادیولوژی</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">در</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">امر</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">آموزش</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">بهره</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">برد</span></span><span dir="LTR"><span style="font-size:9.0pt;">.</span></span><span style="font-family:B Lotus;"><span style="font-size:10.0pt;"></span></span>
<strong>Aim: </strong>The purpose of this study was to determine the rate of agreement between CT scan interpretations of cervical spine trauma patients between emergency medicines and radiology physicians.<br>
<strong>Materials and Methods: </strong>This cross-sectional analytical study was conducted in Shohadaye Haft-e Tir Hospital, Tehran, Iran. The 408 CT scans for patients with cervical spine trauma registered by the Emergency Medicine and Radiology physicians in the second six months of 2017, were compared. The findings were analyzed by SPSS software version 23 using descriptive statistical methods. Kappa coefficient was used to determine the agreement rate of CT scan interpretations of the cervical spine<br>
<strong>Results:</strong> The mean age of patients referring to cervical spine trauma was 32.47±8.72 years old, 69 (17%) were female and 339 (83%) were male. In 297 CT scans, the interpretation of the Emergency Medicine and Radiology residents was the same, which accounts for 725.55% of cases. In the analysis, the Kappa coefficient was 0.612 (p<0.001).<br>
<strong>Conclusion: </strong>Despite the fact that the emergency medicine is somewhat new in Iran, the emergency medicine specialists could increase their knowledge of relevant branches of medicine such as radiology. Because of the differences in interpretation, it is necessary to have additional education and radiology courses in an emergency medicine residency program. These courses can invite experienced emergency medicine or radiology department physicians.<span dir="RTL"></span>
ترومای گردن, سیتیاسکن, گروه طب اورژانس, گروه رادیولوژی
Cervical Trauma, CT scan, Emergency Medicine Residents, Radiology Reidents
115
122
http://aums.abzums.ac.ir/browse.php?a_code=A-10-1-266&slc_lang=fa&sid=1
Mehrdad
Modarresi
مهرداد
مدرسی
drmehrdadmodarresi@yahoo.com
10031947532846009249
10031947532846009249
Yes
Emergency Physician, Iran University of Medical Sciences, Tehran, Iran
متخصص طب اورژانس
Hossein
Shaker
حسین
شاکر
10031947532846009250
10031947532846009250
No
Emergency Medicine Management Research Center, Iran University of Medical Sciences, Tehran, Iran
استادیار طب اورژانس دانشگاه علوم پزشکی ایران
Samira
Vaziri
سمیرا
وزیری
10031947532846009251
10031947532846009251
No
Emergency Medicine Management Research Center, Iran University of Medical Sciences, Tehran, Iran
استادیار طب اورژانس دانشگاه علوم پزشکی ایران