3D打印技术辅助颅内动脉瘤栓塞术的治疗效果及预后影响因素  

Therapeutic effect and prognostic factors of 3D printing technology-assisted intracranial arterial embolization

作　　者：王桂林 杨大为[2] 张龙[2] 陈艳梅 梁佳丽 李野鑫 WANG Guilin;YANG Dawei;ZHANG Long;CHEN Yanmei;LIANG Jiali;LI Yexin(Hebei Medical University,Qinhuangdao 066200,China;The First Hospital of Qinhuangdao,Qinhuangdao 066000,China;Shanhaiguan People's Hospital,Qinhuangdao 066200,China)

机构地区：[1]河北医科大学,河北秦皇岛066200 [2]秦皇岛市第一医院,河北秦皇岛066000 [3]山海关人民医院,河北秦皇岛066200

出　　处：《中国实用神经疾病杂志》2023年第4期427-431,共5页Chinese Journal of Practical Nervous Diseases

摘　　要：目的 探讨3D打印技术辅助颅内动脉瘤栓塞术的治疗效果及预后的影响因素。方法 选取2019-01—2021-01秦皇岛市第一医院收治的262例颅内动脉瘤患者,均接受3D打印技术辅助颅内动脉瘤栓塞术。统计围术期指标及预后情况,采用Logistic回归方程分析预后的影响因素,构建列线图预测模型,并进行内部验证。结果 262例颅内动脉瘤患者均行3D打印技术辅助颅内动脉瘤栓塞术,完全栓塞率88.93%,并发症发生率为3.82%,术后1 a预后不良发生率为16.67%。Logistic回归方程显示,动脉瘤直径(OR=8.399)、NF-κB(OR=5.083)、p73(OR=0.518)、术前Hunt-Hess分级(OR=7.165)是3D打印技术辅助颅内动脉栓塞术后患者预后不良的影响因素(P<0.05)。根据上述4项影响因素构建的预后不良列线图模型的曲线下面积(AUC)为0.976(95%CI:0.934~0.997),敏感度、特异度分别为82.7%、91.3%。结论 3D打印技术辅助颅内动脉栓塞术后患者预后不良的影响因素涉及NF-κB、p73、动脉瘤直径、术前Hunt-Hess分级等,依据上述指标拟合列线图预测模型具有良好的预测效能,有助于指导临床诊治。Objective To investigate the therapeutic effect and prognostic factors of 3D printing technology-assisted intracranial arterial embolization.Methods A total of 262 patients with intracranial aneurysm who were treated in the First Hospital of Qinhuangdao from January 2019 to January 2021 were selected and all received 3D printing technology-assisted intracranial aneurysm surgery.Perioperative indicators and prognosis were counted,Logistic regression equation was used to analyze prognostic factors after 3D printing technology-assisted intracranial arterial embolization,a nomogram prediction model was constructed,and internal verification was performed.Results All of the 262 patients with intracranial aneurysm underwent 3D printing technology-assisted intracranial aneurysm surgery,the complete embolization rate was 88.93%,the complication rate was 3.82%,and the 1-year postoperative poor prognosis rate was 16.67%.Logistic regression equation showed that aneurysm diameter(OR=8.399),NF-κB(OR=5.083),p73(OR=0.518),and preoperative Hunt-Hess grade(OR=7.165)were the most important factors in 3D printing technology-assisted cranial unfavorable prognostic factors after internal artery embolization(P<0.05).The AUC of nomogram model of poor prognosis according to the above four influencing factors was 0.976(95% CI:0.934-0.997),and the sensitivity and specificity were respectively 82.7%,91.3%.Conclusion 3D printing technology-assisted intracranial arterial embolism is associated with NF-κB,p73,aneurysm diameter,preoperative Hunt-Hess classification,etc.The prediction model fitted with the line graph according to the above indexes has good predictive efficacy and is helpful to guide clinical diagnosis and treatment.

关 键 词：3D打印技术 颅内动脉瘤栓塞术 动脉瘤 预后 影响因素 

分 类 号：R743[医药卫生—神经病学与精神病学]