高血压脑出血患者微创血肿清除术后发生脑梗死的危险因素及预测模型构建  

Risk Factors and Predictive Model Construction for Cerebral Infarction in Patients with Hypertensive Intracerebral Hemorrhage After Minimally Invasive Hematoma Removal Surgery

作　　者：闫甜甜 乔俊 周相军 YAN Tiantian;QIAO Jun;ZHOU Xiangjun(Department of Emergency Surgery,Xinyang Central Hospital,Xinyang 464000,China)

机构地区：[1]信阳市中心医院急诊外科,河南信阳464000

出　　处：《河南医学研究》2024年第17期3158-3161,共4页Henan Medical Research

摘　　要：目的探讨高血压脑出血(HCH)患者微创血肿清除术后脑梗死发生风险及其危险因素,构建其风险预测模型。方法回顾收集2019年1月至2022年8月信阳市中心医院136例已接受微创血肿清除术治疗的HCH患者的资料,根据患者术后脑梗死发生情况分为梗死组和未梗死组。收集并对比两组资料,采用单因素和多因素分析HCH患者微创血肿清除术后脑梗死发生的危险因素,构建列线图模型并绘制受试者工作特征(ROC)曲线验证其预测效能。结果136例接受微创血肿清除术的高血压性脑出血患者中38例(27.94%)术后发生脑梗死;经单因素、多因素logistic回归分析提示,脑出血量、收缩压、脑组织移位、高血压病程、舒张压均为接受微创血肿清除术治疗高血压性脑出血患者术后脑梗死发生的危险因素(P<0.05);绘制列线图构建预测术后脑梗死的风险模型,验证模型区分度显示C-index值为0.887,提示区分度良好;绘制标准曲线提示模型准确度良好。绘制ROC曲线提示该模型评估接受微创血肿清除治疗的高血压性脑出血患者术后脑梗死发生曲线下面积为0.887,提示预测效能较好。结论脑出血量、收缩压、脑组织移位、高血压病程、舒张压均为接受微创血肿清除术治疗高血压性脑出血患者术后脑梗死发生的危险因素,基于上述危险因素构建的风险预测模型有较高的预测价值。Objective To explore the risk and risk factors of cerebral infarction in patients with hypertensive intracerebral hemorrhage after minimally invasive hematoma removal surgery,and construct a risk prediction model.Methods Retrospective collect the data of 136 patients with hypertensive cerebral hemorrhage who completed minimally invasive hematoma removal in Xinyang Central Hospital from January 2019 to August 2022.The patient data were consulted and divided into infarct group and non-infarct group according to the occurrence of postoperative cerebral infarction.The clinical data of the two groups were collected and compared.The risk factors of cerebral infarction after minimally invasive hematoma removal in hypertensive intracerebral hemorrhage patients were analyzed by univariate and multivariate analysis.The predictive efficacy was verified by constructing a nomogram model and drawing receiver operating characteristic(ROC)curve.Results Among 136 patients with hypertensive intracerebral hemorrhage,38 cases(27.94%)had secondary cerebral infarction after minimally invasive hematoma removal surgery.After univariate analysis and multivariate logistic regression analysis,the results showed that the course of hypertension,systolic blood pressure,diastolic blood pressure,cerebral hemorrhage volume,and brain tissue displacement were risk factors for cerebral infarction in patients with hypertensive intracerebral hemorrhage after minimally invasive hematoma removal surgery(P<0.05).A column chart model was drawn to construct a risk prediction model for cerebral infarction after minimally invasive hematoma removal in patients with hypertensive intracerebral hemorrhage.The discrimination of the model showed C-index value was 0.887,with good discrimination.The standard curve showed that the calibration curve was similar to the Y-X straight line,and the accuracy of the model was good.The validation of the model’s predictive performance showed that the area under the curve for evaluating the occurrence of cerebral infarction

关 键 词：高血压性脑出血 微创血肿清除术 继发脑梗死 列线图模型 

分 类 号：R743[医药卫生—神经病学与精神病学]