在垂体腺瘤内进行内镜透形外科手术后预测糖尿病 insipidus 的nomogram
Xinming Yu1,2, Guangming Xu1, Peng Qiu1
1Department of Neurosurgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China.
Journal of neuroendocrinology
|December 3, 2024
概括
一个新的名图预测了在下垂体腺瘤 (PA) 手术后的无味糖尿病 (DI) 风险. 它确定了瘤大小和茎偏差等关键因素,有助于临床医生管理接受内镜转形手术 (TSS) 的PA患者的术后护理.
科学领域:
- 神经外科 神经外科
- 内分泌学 在内分泌学.
- 在瘤学瘤学.
背景情况:
- 手术后的糖尿病无味症 (DI) 是对 pituitary adenoma (PA) 进行内透视性透视性手术 (TSS) 后的一个常见并发症.
- 目前缺乏可靠的方法来预测这些患者的DI风险,这阻碍了个性化术后管理.
研究的目的:
- 为了确定在PA的内镜TSS后发展DI的独立风险因素.
- 开发和验证用于评估PA患者手术后DI风险的预测性名谱.
主要方法:
- 一组600名接受内镜TSS的PA患者被追溯分析.
- 患者被分为训练 (n=360) 和验证 (n=240) 组.
- 进行了单变量和多变量后勤回归分析以确定风险因素;使用ROC曲线,校准图和决策曲线分析构建和验证了一个名图.
主要成果:
- 确定的独立风险因素包括最大瘤直径,Knosp等级,Esposito等级,复发性PA和垂体茎偏差角度.
- 开发的名图表显示出强大的预测准确性 (AUC 0.840在训练中,0.815在验证中) 和出色的校准.
- 该模型还显示了区分临时性和永久性DI的能力 (AUC为0.652).
结论:
- 一个经过验证的诺姆图有效地预测了在接受内镜TSS的PA患者中术后的DI风险.
- 该工具有助于识别高风险个体,优化术后护理,并定制治疗策略.
- 诺米图还可以帮助评估发展永久性DI的风险.
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