Du Ning, Wang Xinjun, Zhang Xuyang, Xie Jingwei, Zhou Shaolong, Wu Yuehui, Guo Yongkun
Department of Neurosurgery, The Fifth Affiliated Hospital of Zhengzhou University, 3 Kangfuqian Street, Erqi District, Zhengzhou, Henan, People's Republic of China.
Transl Neurosci. 2021 Apr 20;12(1):145-153. doi: 10.1515/tnsci-2020-0164. eCollection 2021 Jan 1.
This study aimed to determine the safety and effectiveness of DTI-assisted neuroendoscopy for treating intracranial hemorrhage (ICH).
This retrospective study included clinical data from 260 patients with spontaneous supratentorial ICH who received neuroendoscopic hematoma removal. Patients were separated into groups based on the surgery method they received: DTI-assisted neuroendoscopy (69 cases) and standard neuroendoscopy (191 cases). All patients were followed up for 6 months. Multivariate logistic regression analyzed the risk factors affecting the prognosis of patients. The outcomes of the two groups were compared using Kaplan-Meier survival curves.
The prognostic modified Rankin Scale (mRS) score was significantly better ( = 0.027) in the DTI-assisted neuroendoscopy group than in the standard neuroendoscopy group. Logistic regression analysis showed that DTI-assisted neuroendoscopy is an independent protective factor for a favorable outcome (model 1: odds ratio [OR] = 0.42, = 0.015; model 2: OR = 0.40, = 0.013). Kaplan-Meier survival curves were used to show that the median time for a favorable outcome was 66 days (95% confidence interval [CI] = 48.50-83.50 days) in the DTI-assisted neuroendoscopy group and 104 days (95% CI = 75.55-132.45 days) in the standard neuroendoscopy group. Log-rank testing showed that the DTI-assisted neuroendoscopy group had a lower pulmonary infection rate ( = 4.706, = 0.030) and a better prognosis ( = 5.223, = 0.022) than the standard neuroendoscopy group. The survival rate did not differ significantly between the DTI-assisted neuroendoscopy group and the standard neuroendoscopy group ( > 0.05).
The use of DTI in neuroendoscopic hematoma removal can significantly improve neurological function outcomes in patients, but it does not significantly affect the mortality of patients.
本研究旨在确定弥散张量成像（DTI）辅助神经内镜治疗颅内出血（ICH）的安全性和有效性。
这项回顾性研究纳入了260例接受神经内镜血肿清除术的自发性幕上ICH患者的临床资料。根据患者接受的手术方法将其分为两组：DTI辅助神经内镜组（69例）和标准神经内镜组（191例）。所有患者均随访6个月。多因素逻辑回归分析影响患者预后的危险因素。使用Kaplan-Meier生存曲线比较两组的结局。
DTI辅助神经内镜组的改良Rankin量表（mRS）预后评分显著优于标准神经内镜组（P = 0.027）。逻辑回归分析表明，DTI辅助神经内镜是预后良好的独立保护因素（模型1：比值比[OR] = 0.42，P = 0.015；模型2：OR = 0.40，P = 0.013）。Kaplan-Meier生存曲线显示，DTI辅助神经内镜组预后良好的中位时间为66天（95%置信区间[CI] = 48.50 - 83.50天），标准神经内镜组为104天（95%CI = 75.55 - 132.45天）。对数秩检验显示，DTI辅助神经内镜组的肺部感染率低于标准神经内镜组（P = 4.706，P = 0.030），预后更好（P = 5.223，P = 0.022）。DTI辅助神经内镜组与标准神经内镜组之间的生存率差异无统计学意义（P > 0.05）。
在神经内镜血肿清除术中使用DTI可显著改善患者的神经功能结局，但对患者死亡率无显著影响。
