【摘要】 目的 探讨脑室改良的Graeb评分(m GS)对幕上自发性脑室出血(IVH)患者术后慢性脑积水(HCP)的预测价值。方法 回顾性分析169例行手术治疗的幕上自发性IVH患者的临床资料，根据患者出院后3个月内是否形成慢性HCP，将其分为慢性HCP组(49例)和非慢性HCP组(120例)。使用m GS评分评估自发性IVH严重程度。通过单因素和多因素Logistic回归分析，揭示HCP的危险因素，采用受试者特征工作(ROC)曲线分析m GS评分预测HCP的能力。结果 通过多因素Logistic回归分析，脑室m GS评分与HCP独立相关(OR=1.395,95%CI:1.239～1.572,P <0.001)，同时结果还显示GCS评分为HCP的独立影响因素(P <0.05)。脑室m GS评分的曲线下面积(AUC)为0.870(95%CI:0.810～0.917,P <0.001)，灵敏度89.8%，截断值14分。结论 m GS评分具有预测幕上自发性IVH患者术后慢性HCP的价值。脑室m GS评分>14时，患者术后更易形成慢性HCP。更多还原

【Abstract】 Objective To investigate predictive value of modified Graeb Scale Score( m GS) on postoperative chronic hydrocephalus( HCP) for patients with supratentorial spontaneous intraventricular hemorrhage( IVH).Methods The clinical data of 169 patients with supratentorial spontaneous IVH treated by surgery were analyzed retrospectively. According to whether the patients formed chronic HCP within 3 months after discharge,they were divided into the chronic HCP group( 49 cases) and the non-chronic HCP group( 120 cases). The severity of spontaneous IVH was evaluated by m GS score. The risk factors of HCP were revealed using univariate and multivariate logistic regression analysis,and the ability of m GS score to predict HCP was analyzed by subject characteristic work receiver operating characteristic( ROC) curve. Results Multivariate binary logistic regression analysis showed that m GS was independently correlated with chronic HCP( OR = 1. 395,95% CI: 1. 239-1. 572,P < 0. 001). The result also revealed that GCS was an independent risk factor( P < 0. 05). The area under the curve( AUC) of m GS was 0. 870( 95% CI: 0. 810-0. 917,P < 0. 001),sensitivity was 89. 8% and cut-off value was 14.Conclusion The m GS has great predictive value on postoperative chronic HCP for patients with supratentorial spontaneous IVH,when the m GS score is greater than 14,the patients may be more likely to develop chronic HCP.更多还原