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.
作者
王桂林
杨大为
张龙
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)
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
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
3D printing technology
Embolization of intracranial arterial
Aneurysm
Prognosis
Influencing factors
