改良的Graeb评分对幕上自发性脑室出血患者术后慢性脑积水预测价值  

Analysis on modified Graeb Scale Score on predicting postoperative chronic hydrocephalus for patients with supratentorial spontaneous intraventricular hemorrhage

作　　者：王如海 胡海成[1] 韩超[1] 于强[1] 李习珍 黄好峰 WANG Ru-hai;HU Hai-cheng;HAN Chao(Department of Neurosurgery,Fuyang Fifth People s Hospital,Fuyang 236063,China)

机构地区：[1]阜阳市第五人民医院神经外科,阜阳236063

出　　处：《临床神经外科杂志》2022年第4期445-449,452,共6页Journal of Clinical Neurosurgery

基　　金：安徽省科技重大专项项目(201903a07020006)。

摘　　要：目的探讨脑室改良的Graeb评分(mGS)对幕上自发性脑室出血(IVH)患者术后慢性脑积水(HCP)的预测价值。方法回顾性分析169例行手术治疗的幕上自发性IVH患者的临床资料,根据患者出院后3个月内是否形成慢性HCP,将其分为慢性HCP组(49例)和非慢性HCP组(120例)。使用mGS评分评估自发性IVH严重程度。通过单因素和多因素Logistic回归分析,揭示HCP的危险因素,采用受试者特征工作(ROC)曲线分析mGS评分预测HCP的能力。结果通过多因素Logistic回归分析,脑室mGS评分与HCP独立相关(OR=1.395,95%CI:1.239~1.572,P<0.001),同时结果还显示GCS评分为HCP的独立影响因素(P<0.05)。脑室mGS评分的曲线下面积(AUC)为0.870(95%CI:0.810~0.917,P<0.001),灵敏度89.8%,截断值14分。结论mGS评分具有预测幕上自发性IVH患者术后慢性HCP的价值。脑室mGS评分>14时,患者术后更易形成慢性HCP。Objective To investigate predictive value of modified Graeb Scale Score(mGS)on postoperative chronic hydrocephalus(HCP)for patients with supratentorial spontaneous intraventricular hemorrhage(IVH).Methods The clinical data of 169 patients with supratentorial spontaneous IVH treated by surgery were analyzed retrospectively.According to whether the patients formed chronic HCP within 3 months after discharge,they were divided into the chronic HCP group(49 cases)and the non-chronic HCP group(120 cases).The severity of spontaneous IVH was evaluated by mGS score.The risk factors of HCP were revealed using univariate and multivariate logistic regression analysis,and the ability of mGS score to predict HCP was analyzed by subject characteristic work receiver operating characteristic(ROC)curve.Results Multivariate binary logistic regression analysis showed that mGS was independently correlated with chronic HCP(OR=1.395,95%CI:1.239-1.572,P<0.001).The result also revealed that GCS was an independent risk factor(P<0.05).The area under the curve(AUC)of mGS was 0.870(95%CI:0.810-0.917,P<0.001),sensitivity was 89.8%and cut-off value was 14.Conclusion The mGS has great predictive value on postoperative chronic HCP for patients with supratentorial spontaneous IVH,when the mGS score is greater than 14,the patients may be more likely to develop chronic HCP.

关 键 词：自发性脑室出血 慢性脑积水 受试者特征工作曲线 改良的Graeb评分 

分 类 号：R743.34[医药卫生—神经病学与精神病学] R742.7[医药卫生—临床医学]