神经导航引导下治疗基底节高血压脑出血的短期疗效预测  

Short-term efficacy prediction of neuronavigation-guided treatment of basal ganglia hypertensive intracerebral hemorrhage

作　　者：景方坤 周建波[1] 王全才[1] 黄海韬[1] 李岩峰[1] 徐杨熙 Fangkun Jing;Jianbo Zhou;Quancai Wang;Haitao Huang;Yanfeng Li;Yangxi Xu(Department of Neurosurgery,Liaoning Provincial People's Hospital,Shenyang 110000,China)

机构地区：[1]辽宁省人民医院神经外科,沈阳110000

出　　处：《中华脑科疾病与康复杂志(电子版)》2024年第3期154-159,共6页Chinese Journal of Brain Diseases and Rehabilitation(Electronic Edition)

基　　金：辽宁省自然科学基金项目(2022‑MS‑074)

摘　　要：目的探讨神经导航引导下治疗基底节高血压脑出血(HICH)的短期疗效及其预测。方法回顾性分析辽宁省人民医院神经外科自2020年1月至2021年6月收治的56例基底节HICH患者的临床资料。按照穿刺定位方法的不同分为2组,对照组(35例)应用传统定位法穿刺治疗,试验组(21例)应用神经导航辅助定位穿刺治疗。对比2组患者术后1周GCS评分、并发症和术后6个月Barthel指数(BI)评分;采用多因素Logistic回归分析研究基底节HICH不同术式的获益因素,通过R软件构建列线图风险预测模型并验证效果。结果2组患者术后并发症肺内感染、应激性溃疡发生率比较,差异无统计学意义(P>0.05);试验组在术后1周GCS评分高于对照组,残余血量和住院天数低于对照组,手术时间长于对照组,治疗后6个月BI评分优于对照组,差异均有统计学意义(P<0.05)。多因素Logistic回归分析显示术后残余血量和住院时间为基底节HICH患者术后疗效的独立影响因素,据此构建列线图模型,Bootstrap法内部验证显示Calibrate曲线图显示模型校准度良好。结论神经导航辅助下治疗基底节HICH手术治疗可减少术后脑内残余血量,降低患者住院天数,促进术后远期生活自理能力的恢复,为促进脑出血患者康复和尽早回归社会提供新的治疗方案。Objective To explore and predict the short-term efficacy of neuronavigation-guided treatment for basal ganglia hypertensive intracerebral hemorrhage(HICH).Methods A retrospective analysis was conducted on the clinical data of 56 patients with basal ganglia HICH admitted to Neurosurgery Department of Liaoning Provincial People's Hospital from January 2020 to June 2021.According to different puncture positioning methods,they were divided into two groups.The control group(35 cases)received traditional localization puncture treatment,while the experimental group(21 cases)received neuronavigation-guided localization puncture treatment.The GCS score at 1 week after surgery,complications and the Barthel index(BI)score at 6 months after surgery between the two groups were compared.Multivariate Logistic regression were used to analyze the benefit factors of different surgical methods for basal ganglia HICH,and the R software was used to construct a nomogram risk prediction model and verify the effect.Results There was no statistical difference in intra-pulmonary infections,and the incidence of stress ulcers between the two groups(P>0.05).The experimental group had a higher GCS score at 1 week after surgery than the control group,lower residual blood volume and hospitalization days than the control group,the longer surgical operation time than the control group,and the BI score at 6 months after treatment was better than that of the control group,with statistical significances(P<0.05).Multivariate Logistic regression analysis showed that postoperative residual blood volume and hospitalization days were independent benefit factors.The internal verification of the Bootstrap method showed that the calibration curve showed that the model was well calibrated.Conclusion Surgical treatment of basal ganglia HICH assisted by neuronavigation can reduce postoperative intracerebral residual blood and hospitalization days,promote the recovery of long-term self-care ability after surgery,and provide a new therapeutic option for promotin

关 键 词：高血压脑出血 基底节 神经导航 手术治疗 列线图 

分 类 号：R651.1[医药卫生—外科学]