慢性硬膜下血肿行钻孔引流术后复发的风险因素分析及列线图预测模型构建

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Risk factors analysis for recurrence after burrhole drainage in chronic subdural hematoma and construction of a nomogram prediction model ZHANG Min， CHEN Weiwei， XIE Xie， ZHANG Jie，WANG Zipu. Department of Neurosurgery，Lu'an People's Hospital，Lu'an 237OoO，China

Abstract：ObjectiveTo investigate potential risk factors influencing postoperative recurrence in chronic subdural hematoma（CSDH）patients undergoing burrhole drainage and to.construct a nomogram prediction model. MethodsThe clinical data of226 CSDH patients who underwent burr hole drainage in Department of Neurosurgery， Lu'anPeople'sHospitalfrom January2O2OtoOctober 2O24wereanalyzedretrospectively.Independentriskfactors for postoperative recurrencewere identifiedusing multivariate Logisticregressionanalysis，andanomogram prediction model was developed.The model's discrimination，calibration performance，and clinical utilitywere evaluated using receiveroperating characteristic（ROC）curves，calibration curves，and decision curve analysis（DCA）curves. ResultsAmong 226 patients， 23 cases（10.18%） experienced recurrence within 3 months postoperatively. Group comparisons revealed statistically significant differences in age，hematoma width，and T2 hematoma signal between the recurrence group（ n=23 ）and the non-recurrence group（ n=203 ）（ P<0.05 ）．Multivariate Logistic regression analysis demonstrated that age（ OR=1.06，P=0.033， ），heterogeneous MRI- I2 signal（ （OR=3.53，P=0.013 ），and hematomawidth（ OR=2 .18 3，P=0.020 ）were independent risk factors.The constructed nomogram prediction model exhibited excelent calibration performance and discrimination，area under curve（AUC）=0.90（0.86，0.94），and provided significant net clinical benefit indecision curveanalysis.ConclusionsAge，heterogeneous MRI- ⋅I2 signal， and hematoma width are independent risk factors forpostoperative recurrence in CSDH patients.The nomogram prediction model servesasan effective preoperativeassessment tool for clinicians，aiding in theoptimization of surgical strategies and improving prognosis for patients.

Key words：chronic subdural hematoma；burr hole drainage；postoperative recurrence；risk factors；nomogram prediction model

慢性硬膜下血肿（chronicsubduralhematoma，CSDH）是神经外科的常见病，尤其在老年人群中发病率较高[1-3]。（剩余10917字）