摘要
目的探讨脑膜瘤患者显微术后脑水肿加重的影响因素,并构建列线图模型进行预测和验证。方法回顾性收集2012年9月至2022年9月驻马店市第一人民医院收治的180例行显微术脑膜瘤患者的临床资料,依据术后脑水肿加重情况分为脑水肿加重组(40例)和脑水肿未加重组(140例)。采用Logistic回归分析影响脑膜瘤患者显微术后脑水肿加重的因素,根据回归分析结果构建风险预测模型,利用R软件构建列线图,并绘制受试者工作特征曲线评估风险模型的预测效能。结果两组患者性别、年龄、肿瘤长径、Simpson分级、高血压、糖尿病、心脏病情况比较,差异未见统计学意义(P>0.05);脑水肿加重组术中静脉损伤、术前癫痫、肿瘤部位与脑水肿未加重组比较差异有统计学意义(P<0.05)。Logistic回归分析结果显示,术前癫痫、肿瘤部位、术中静脉损伤是脑膜瘤患者显微术后脑水肿加重的危险因素(OR>1,P<0.05)。绘制列线图构建脑膜瘤患者显微术后脑水肿加重风险预测模型,验证模型的区分度显示C-index=0.824,说明该模型具有良好的区分度;绘制标准曲线显示,校准曲线和Y-X直线相近,模型准确度良好;对模型预测效能进行验证,风险模型评估脑膜瘤患者显微术后脑水肿加重的曲线下面积为0.824,95%CI为0.751~0.898,P<0.001。结论肿瘤部位、术前癫痫、术中静脉损伤是脑膜瘤患者显微术后脑水肿加重的影响因素,基于以上因素构建的脑膜瘤患者显微术后脑水肿加重的风险预测模型具有一定的预测价值。
Objective To investigate the influencing factors of brain edema exacerbation after microscopic surgery for meningioma,and to construct a column chart model for prediction and validation.Methods The clinical data of 180 patients with meningioma treated by microscopic surgery in the First People’s Hospital of Zhumadian from September 2012 to September 2022 were retrospectively collected.According to the severity of postoperative brain edema,they were divided into brain edema exacerbation group(40 cases)and the non-worsen brain edema group(140 cases).Logistic regression analysis was used to analyze the factors affecting the exacerbation of brain edema after microscopic surgery in patient with meningioma.A risk prediction model was constructed based on the regression analysis results,and a column chart was constructed using R software.The predictive efficacy of the risk model was evaluated by drawing the receiver operating characteristic curve.Results There was no significant difference in gender,age,tumor major diameter,Simpson grade,hypertension,diabetes and heart disease between the two groups(P>0.05).There were significant differences in venous injury,preoperative epilepsy,and tumor location between the brain edema exacerbation group and the no-worsen brain edema group(P<0.05).Results of logistic regression analysis showed that preoperative epilepsy,tumor location and intraoperative venous injury were risk factors for brain edema exacerbation after microscopic surgery for meningioma(OR>1,P<0.05).The discrimination of prediction model,constructed by column chart,for risk of brain edema exacerbation after microscopic surgery for meningioma showed that C-index=0.824,indicating that the model had good discrimination.The standard curve showed that the calibration curve was similar to the Y-X line,and the accuracy of the model was good.The area under the curve of the risk model for evaluating the brain edema exacerbation after microscopic surgery for meningioma was 0.824,and the 95%CI was 0.751-0.898,P<0.001.Conclusions The influencing factors for brain edema exacerbation after microscopic surgery for meningioma include tumor location,preoperative epilepsy and intraoperative venous injury.The risk prediction model based on the above factors has certain predictive value for the brain edema exacerbation after microscopic surgery for meningioma.
作者
王德群
刘海巍
陈辉
Wang Dequn;Liu Haiwei;Chen Hui(Department of Neurosurgery,the First People’s Hospital of Zhumadian,Zhumadian 463000,China)
出处
《中国实用医刊》
2024年第3期37-41,共5页
Chinese Journal of Practical Medicine
关键词
脑膜瘤
显微术
脑水肿
列线图模型
Meningioma
Microscopic surgery
Brain edema
Column chart model
