Objective To explore the related risk factors of hydrocephalus in Fisher grade Ⅲ-Ⅳ patients.Methods 313 Fisher Ⅲ-Ⅳ patients of ruptured aneurysm treated in the Department of Neurosurgery,General Hospital of Ningxia Medical University from May 2015 to January 2022 were included.The clinical data of two groups of patients with hydrocephalus and non-hydrocephalus according to different treatment methods were collected,and the independent risk factors of hydrocephalus were analyzed by multivariate logistic regression.The predictive model was constructed by independent risk factors,and combined with the receiver operating characteristic(ROC)curve analysis model to predict the value of patients with hydrocephalus.Results Univariate analysis showed that postoperative hydrocephalus in patients with clipping and coiling was associated with Fisher Ⅳ grade(P=0.004),subarachnoid continuous lumbar drainage(LD)(P=0.017),and Hunt-Hess Ⅲ-Ⅴ grade(P=0.003),Fisher Ⅳ grade(P=0.005),decompressive craniectomy(P=0.042),and pneumonia(P=0.016),respectively.Based on multiple factor analysis,it is concluded that the independent risk factors of hydrocephalus after clipping were FisherⅣ grade[P=0.007,odds ratio(OR)=17.949,OR 95％confidence interval(CI):2.181-147.682],and LD(P=0.003,OR=4.717,OR 95％CI:1.486-89.027).ROC curve analysis showed that Fisher Ⅳ grade+LD(AUC=0.747 8,95％CI:0.644 3-0.851 4,P=0.000 2,PH-L=0.851).The independent risk factors of hydrocephalus after coiling were Fisher Ⅳ(P=0.048,OR=3.598,OR 95％CI:1.014-12.768)and Hunt Hess Ⅲ-Ⅴ(P=0.039,OR=8.610,OR 95％CI:1.13-66.583).ROC curve analysis showed that Fisher Ⅳ grade+Hunt LessⅢ-Ⅴ grade(AUC=0.7051,95％CI:0.617 5-0.792 6,P=0.000 8,PH-L=0.789).Conclusions Different treatment methods can lead to different independent risk factors of hydrocephalus in patients with intracranial ruptured aneurysms of Fisher Ⅲ-Ⅳ grade.The factors of clipping and coiling were Fisher Ⅳ,LD,and Fisher Ⅳ,Hunt Hess Ⅲ-Ⅳ,respectively.
维普
万方数据
