Đặc điểm vi xuất huyết não và nguy cơ chuyển dạng xuất huyết ở bệnh nhân nhồi máu não cấp có điều trị tái thông=Characteristics of cerebral microbleeds and risk of hemorrhagic transformation in patients with acute cerebral infarction undergoing revascularization therapy

0 Người đánh giá. Xếp hạng trung bình 0

Tác giả: Mạnh Hà Kiều

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Thần kinh học, 2024

Mô tả vật lý: tr.8-19

Bộ sưu tập: Metadata

ID: 225453

Thêm vào giỏ

Đánh giá đặc điểm vi xuất huyết não và các yếu tố liên quan đến chuyển dạng xuất huyết ở bệnh nhân nhồi máu não cấp có điều trị tái thông tại bệnh viện Đại học Y Dược TP. HCM. Đối tượng và phương pháp: Nghiên cứu cắt ngang mô tả kết hợp theo dõi hồ sơ bệnh án trên 79 bệnh nhân được chẩn đoán nhồi máu não (NMN) cấp được nhập viện và điều trị tại Khoa Thần kinh Bệnh viện Đại học Y Dược Thành phố Hồ Chí Minh. Kết quả: Bệnh nhân có vi xuất huyết (VXH) chiếm 37,97% Số lượng từ 1- 4 VXH chiếm tỷ lệ cao nhất là 31,65%, chỉ có 01 trường hợp có trên 10 VXH chiếm tỷ lệ 1,27%. Vị trí VXH chủ yếu là ở khu vực não sâu chiếm 21,52%. Có mối liên quan giữa VXH và rối loạn lipid máu với p = 0,16 (OR 4,12, CL 1,14-18,47), bệnh lý chất trắng theo phân loại Fazekas với p = 0,041. Các biến chứng chuyển dạng xuất huyết (CDXH) sau tái thông chủ yếu là nhồi máu xuất huyết (HI) chiếm tỷ lệ 26,58%, tiếp đó là tụ máu nhu mô (PH) chiếm tỷ lệ 6,33% và ICH+ chiếm tỷ lệ 3,8%. Có mối liên quan giữa thang điểm Glasgow (OR = 1,66, KTC 0,79 - 3,51) với NMN CDXH có triệu chứng (sICH) và PH với p <
0,05. Tìm thấy mối liên quan giữa Thang điểm NIHSS và ICH với p = 0,037 (OR = 5,46 KTC 1,10 – 19,00). Chưa đủ bằng chứng để kết luận về mối liên quan giữa số lượng, vị trí vi xuất huyết với biến chứng chuyển dạng xuất huyết sau tái thông. Kết luận: VXH không phải là một yếu tố đề trì hoãn các biện pháp can thiệp tái thông trên bệnh nhân NMN cấp có chỉ định can thiệp. Các bệnh nhân có nguy cơ cao mắc nhiều VXH nên được chụp CHT trước can thiệp.Evaluate the characteristics of cerebral microbleeds and factors related to hemorrhagic transformation in patients with acute cerebral infarction undergoing revascularization treatment at University Medical Center, Ho Chi Minh City. Subjects and methods: Cross-sectional descriptive study combined with medical record monitoring on 79 patients diagnosed with acute cerebral infarction who were admitted and treated at the Department of Neurology, University Medical Center, Ho Chi Minh City. Results: Patients with microhemorrhage (VXH) accounted for 37.97%. The number of 1-4 VXH accounted for the highest rate of 31.65%, only 01 case had more than 10 VXH, accounting for 1.27% %. The location of social lesions is mainly in the deep brain area, accounting for 21.52%. There is an association between VXH and dyslipidemia with p = 0.16 (OR 4.12, CL 1.14- 18.47), white matter pathology according to Fazekas classification with p = 0.041. The main complications of hemorrhagic transformation after revascularization are hemorrhagic infarction (HI), accounting for 26.58%, followed by parenchymal hematoma PH, accounting for 6.33%, and ICH+, accounting for 3.8%. There is an association between Glasgow scale (OR = 1.66, CI 0.79 - 3.51) with symptomatic ICH and PH with p <
0.05. Found an association between NIHSS Scale and ICH with p = 0.037 (OR = 5.46 CI 1.10 – 19.00). There is not enough evidence to conclude about the relationship between the number and location of microbleeds and complications of hemorrhagic transformation after revascularization. Conclusion: VXH is not a factor to delay recanalization interventions in acute myocardial infarction patients with indications for intervention. Patients at high risk of multiple VHs should have an MRI scan before intervention.

1. Đọc trực tuyến

1. Đọc trực tuyến

Tạo bộ sưu tập với mã QR