【摘要】 目的 探讨幕上自发性脑出血后急性脑积水(AHCP)发生的影响因素并建立可视化的动态列线图预测工具。方法 收集2019年1月至2023年1月就诊于福建医科大学附属第二医院神经外科的359例幕上自发性脑出血合并AHCP患者的临床资料。通过多因素logistic回归分析，筛选出幕上自发性脑出血后AHCP的影响因素为年龄、血磷、脑室内出血，构建基于这些因素的预测模型应用程序接口(API),并开发动态列线图及其网页应用。结果 多因素分析结果显示，年龄(OR=1.045,P<0.001)、脑室出血(OR=3.034,P<0.001)和血磷(OR=2.717,P=0.012)是幕上自发性脑出血后AHCP发生的影响因素，构建API预测模型的受试者工作特征(ROC)曲线下面积(AUC)为0.711,校准曲线显示模型预测与实际观察高度一致，且决策曲线分析表明模型具有良好的临床有效性和判别能力。结论 高龄、高血磷和脑室内出血是幕上自发性脑出血后AHCP发生的危险因素。基于此建立的API列线图模型，可预测幕上自发性脑出血后AHCP的发生概率。更多还原

【Abstract】 Objective To investigate the influencing factors of acute hydrocephalus(AHCP) following supratentorial spontaneous intracerebral hemorrhage(ICH) and develop a visual dynamic nomogram prediction tool.Methods Clinical data from 359 patients with supratentorial spontaneous ICH complicated by AHCP, admitted to the Department of Neurosurgery, the Second Affiliated Hospital of Fujian Medical University from January 2019 to January 2023, were retrospectively analyzed. Multivariate logistic regression was used to identify independent predictors of AHCP, including age, blood phosphorus level, and intraventricular hemorrhage. A predictive model based on these factors was constructed, along with an application programming interface(API), and a dynamic nomogram with an accompanying web application was developed.Results Multivariate analysis revealed that age(OR=1.045, P<0.001), intraventricular hemorrhage(OR=3.034, P<0.001), and blood phosphorus level(OR=2.717, P=0.012) were significant predictors of AHCP after supratentorial spontaneous ICH. The API-based prediction model demonstrated an area under the receiver operating characteristic(ROC) curve(AUC) of 0.711. Calibration curves indicated strong agreement between predicted and observed outcomes, and decision curve analysis confirmed the model’s clinical utility and discriminative ability. Conclusion Advanced age, elevated blood phosphorus levels, and intraventricular hemorrhage are independent risk factors for AHCP following supratentorial spontaneous ICH. The developed API-based nomogram model effectively predicts the probability of AHCP occurrence in this patient population.更多还原