摘要
Abstract
Objective To establish and validate a risk prediction model for postoperative epilepsy in patients with hypertensive intracerebral hemorrhage(HICH).Methods The medical records of 246 HICH patients who underwent soft channel puncture hematoma cavity drainage in the Second People's Hospital of Changde,from May 2022 to March 2024 were retrospectively analyzed and randomly divided into the training set(197 cases)and the verification set(49 cases)according to the 8:2 law.Two weeks after surgery,HICH patients of the training set were divided into occurrence group(28 cases)and non-occurrence group(169 cases)according to whether epilepsy occurred after surgery.The clinical data of the occurrence group and the non-occurrence group were compared.The influencing factors of epilepsy after soft channel puncture hematoma cavity drainage in patients with HICH were analyzed through the Logistic regression model.The Nomogram model was constructed,and the predictive value of the nomogram model was evaluated by the ROC curve and calibration curve.Results The incidence of epilepsy in the training set was 14.21%.The incidence of epilepsy in the validation set was 16.33%.Statistically significant differences were observed between patients of the occurrence and non-occurrence groups in terms of the National Institutes of Health Stroke Scale(NIHSS)score,hypertension duration,hydrocephalus,hematoma volume≥60 cm3,postoperative rebleeding,drainage tube contamination,tumor necrosis factor α(TNF-α)and neuron-specific enolase(NSE)(t/χ2=10.644,4.950,16.661,38.273,26.013,19.824,12.699,25.707;P<0.05).Logistic regression analysis showed that NIHSS score,hematoma volume,TNF-α and NSE at admission were the influencing factors for postoperative epilepsy in HICH patients(OR=4.655,5.228,4.145,3.881;P<0.05).The area under the curve of the training set model was 0.905,the sensitivity was 89.29%,and the specificity was 90.53%for predicting postoperative epilepsy after soft channel puncture hematoma cavity drainage in HICH patients.The area under the curve of the validation set model for predicting postoperative epilepsy after soft channel puncture hematoma cavity drainage in HICH patients was 0.897,with a sensitivity of 87.50%,and a specificity of 90.24%.Conclusion NIHSS score,hematoma volume,TNF-α and NSE at admission are associated with postoperative epilepsy after soft channel puncture hematoma cavity drainage in patients with HICH.The constructed nomogram model can effectively predict the risk of epilepsy after soft channel puncture hematoma cavity drainage in patients with HICH.关键词
高血压脑出血/软通道穿刺血肿腔引流术/影响因素/癫痫/风险预测模型Key words
Hypertensive intracerebral hemorrhage/Soft channel puncture hematoma cavity drainage/Influencing factors/Epilepsy/Risk prediction model
