摘要
目的 :探讨脑室出血并发出血后脑积水 (PHH)预测方法。方法 :按Graeb与修改Graeb二种不同标准 ,对 131例各部位的脑室出血 (包括第三、第四脑室出血组 6 4例 ,与侧脑室出血组 6 7例 )作积血评分与并发PHH的临床观察 ,用四格表确切概率法分析界点值时各诊断参数的效度 ,用成组logistic回归分析法计算各积分点并发PHH的概率。结果 :在第三、第四脑室组其敏感性 (Se)、特异性 (Sp)、Kappa值 (K) ,按Graeb标准分别为 0 .75 ,0 .77和 0 .4 0 ;而按修改Graeb标准 ,分别为 0 .90 ,0 .85和 0 .6 9。在侧脑室出血组其Se,Sp与K ,按Graeb标准分别为0 .90 ,0 .84和 0 .73;而按修改Graeb标准分别为 0 .90 ,0 .87和 0 .74。在全脑室系统出血组其Se,Sp与K ,按Graeb标准分别为 0 .78,0 .84和 0 .6 0 ;而按修改Graeb标准分别为 0 .90 ,0 .84和 0 .74。按修改Graeb标准在积分点 3～12分值时并发PHH的概率分别为 0 .0 13,0 .0 36 ,0 .0 96 ,0 .2 30 ,0 .4 5 4 ,0 .6 98,0 .86 6 ,0 .94 7,0 .980和 0 .994。结论 :用修改Graeb标准结合logistic回归分析法 ,可作为脑室系统各部位出血并发PHH预测的重要方法。
Objective To explore the methods of predicting acute post hemorrhagic hydrocephalus (PHH) in intraventricular hemorrhage (IVH).Methods According to the main location of blood deposit in the ventricular system, 131 patients with primary and secondary IVH were divided into 2 groups: the lateral ventricle group (LVG) in which 67 patients were filled in bilateral ventricles, and the third and fourth ventricle group (TFVG) in which 64 patients were filled in the third and the fourth ventricles. The IVH was scored by Graeb criteria and modified Graeb criteria. The sensitivity (Se), specificity (Sp), and Kappa value (K) were studied by exact probabilities in 2×2 tables in the cutoff point. The probability of PHH was studied by binary Logistic regression. Results In TFVG, according to Graeb criteria in the cutoff point, Se, Sp, and K were 0.75, 0.77 and 0.40; while based on modified Graeb criteria, they were 0. 90, 0.85 and 0.69 respectively. In LVG, according to Graeb criteria, Se,Sp and K were 0.90,0.84,and 0.73; while to modified Graeb criteria,those were 0. 90, 0.87 ,and 0.74 respectively. In the whole group, by Graeb criteria in the cutoff point, Se,Sp and K were 0.78 , 0.84,and 0.60 respectively; and by modified Graeb criteria those were 0.90, 0.84,and 0.74 . The probability of PHH from 3 to 12 was 0.013, 0.036, 0.096, 0.230, 0.454, 0.698, 0.866 , 0.947, 0.980 and 0.994 respectively by modified Graeb criteria.Conclusion The modified Graeb criteria combined with logistic regression analysis would be a useful and practical method to predict the probability of PHH in IVH.
出处
《湖南医科大学学报》
CSCD
北大核心
2003年第5期517-520,共4页
Bulletin of Hunan Medical University
关键词
脑室出血
脑积水
预测
intraventricular hemorrhage
post hemorrhagic hydrocephalus
prediction
