ETVSS高分值患者ETV失败的相关因素分析

Analysis of risk factors for failure of ETV in patients with the highest ETV success scores

目的探讨ETVSS高分值患者神经内镜下第三脑室底造瘘术失败的影响因素。方法回顾性分析郑州大学第一附属医院神经外科接受ETV手术的患者,收集ETVSS量表分值80和90分患者的临床资料,提取患者病因、性别、临床症状与体征、手术是否成功等信息,运用单因素分析和多因素分析寻找ETVSS高分值患者ETV失败发生的相关因素。结果收集病例81例,ETV失败18例,发生率为22.2%。单因素分析显示,癫痫症状(χ2=20.250,P=0.000)、意识障碍(χ2=46.212,P=0.000)为ETV失败发生的危险因素。多因素非条件Logistic回归分析显示癫痫症状(OR=8.727,P=0.022)、意识障碍(OR=72.417,P=0.000)为ETV失败的独立危险因素。结论癫痫症状、意识障碍是影响ETVSS高分值患者ETV失败的危险因素,且这二者均为ETV失败的独立危险因素。

Objective To investigate the factors affecting the failure of endoscopic third ventriculostomy in patients with the highest ETV success scores. Methods A retrospective review was performed of all patients treated with ETV at Department of Neurosurgery of First Affiliated Hospital of Zhengzhou University. Patients with a preoperative ETVSS of 80 or 90 were identi- fied. The patients＂ etiology, gender, clinical symptoms and signs and outcome were recorded. Analysis and multivariate analysis were used to find the risk factors for the failure of ETV in patients with high score of ETVSS scale. Results 81 patients met entry criteria for the study,]8 of them had a ETV failure, the incidence was 22.2%. Univariate analysis showed that epilepsy （X2 = 20. 250, P = 0. 000） and disturbance of consciousness （X2 = 46. 212, P =0. 000） were the risk factors for failure of ETV. Nonconditional Logistic regression analysis showed that epilepsy （OR = 8. 727, P = 0. 0022） and disturbance of consciousness （OR = 72. 417,P=0. 000） were independent risk factors for ETV failure. Conclusion Epilepsy and disturbance of consciousness are the risk factors for ETV failure in ETV high score patients, and both the two symptoms and signs are independent risk factors for ETV failure.