摘要
目的探讨高血压性脑出血(HICH)患者术后慢性意识障碍(pDoC)的影响因素并构建预测模型。方法选择HICH患者188例,根据术后是否发生pDoC分为pDoC组(66例)和非pDoC组(122例)。比较两组患者年龄、脑疝发生率、慢性脑积水发生率及入院时格拉斯哥昏迷量表(GCS)评分。采用Logistic回归分析HICH术后发生pDoC的影响因素,并构建列线图预测模型。结果pDoC组患者年龄、脑疝发生率、慢性脑积水发生率均高于非pDoC组(P<0.05),入院时GCS评分低于非pDoC组(P<0.05)。Logistic回归分析显示年龄、脑疝、慢性脑积水、入院时GCS评分是HICH患者术后发生pDoC的独立影响因素(P<0.05)。列线图模型预测术后pDoC的ROC曲线下AUC为0.867,灵敏度和特异度分别为93.90%和72.30%。结论HICH术后pDoC的发生受年龄、脑疝、慢性脑积水和入院时GCS评分影响,基于这些因素构建的列线图模型对pDoC的发生具有良好的预测价值。
Aim To explore the influencing factors of prolonged disorders of consciousness(pDoC)after hypertensive intracerebral hemorrhage(HICH)surgery and construct a prediction model.Methods A total of 188 HICH patients were divided into a pDoC group(66 cases)and a non-pDoC group(122 cases)according to postoperative pDoC occurrence.The age,incidence of cerebral hernia,incidence of chronic hydrocephalus and Glasgow coma scale(GCS)score on admission were compared between the two groups.Logistic regression analysis was used to identify influencing factors for occurrence of pDoC after HICH,and a nomogram prediction model was constructed.Results The pDoC group had higher age,incidence of cerebral hernia and chronic hydrocephalus,but lower GCS score on admission compared with the non-pDoC group(P<0.05).Logistic regression analysis showed that age,cerebral hernia,chronic hydrocephalus and GCS score on admission were independent influencing factors for pDoC after HICH surgery(P<0.05).The nomogram model showed AUC of ROC curve of 0.867 for predicting pDoC,with sensitivity and specificity of 93.90%and 72.30%,respectively.Conclusion The occurrence of pDoC after HICH surgery is influenced by age,cerebral hernia,chronic hydrocephalus and GCS score on admission.The nomogram model based on these factors has good predictive value.
作者
何茜
樊朝凤
唐敏
王潘婷
HE Qian;FAN Chaofeng;TANG Min;WANG Panting(Department of Neurosurgery,West China Hospital of Sichuan University,Chengdu 610000,Sichuan,China)
出处
《中南医学科学杂志》
2025年第4期622-625,共4页
Medical Science Journal of Central South China
基金
四川省科技计划项目(2020YJ0033)。
作者简介
何茜,护师,研究方向为神经相关疾病护理,E-mail为heqian6513@163.com;通信作者:樊朝凤,副主任护师,研究方向为神经相关疾病护理,E-mail为165395791@qq.com。
