Nghiên cứu hiệu quả của điều trị tái tưới máu trên bệnh nhân nhồi máu não tuần hoàn sau tại Bệnh viện Đà Nẵng=Investigation on the effectiveness of reperfusion treatment on patients with posterior cerebral infarction at Da Nang Hospital

0 Người đánh giá. Xếp hạng trung bình 0

Tác giả: Huy Hoàng Nguyễn, Thành Trung Nguyễn, Như Thông Phạm

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Y học Việt Nam (Tổng hội Y học Việt Nam), 2024

Mô tả vật lý: tr.148-155

Bộ sưu tập: Metadata

ID: 242212

Thêm vào giỏ

Đánh giá hiệu quả của điều trị tái tưới máu trên bệnh nhân nhồi máu não tuần hoàn sau và mối liên quan giữa các đặc điểm lâm sàng, cận lâm sàng với hiệu quả của điều trị tái tưới máu. Đối tượng và phương pháp: Nghiên cứu cắt ngang mô tả trên 30 bệnh nhân (BN) nhồi máu não (NMN) cấp tuần hoàn sau được điều trị tái tưới máu nhập viện từ tháng 06/2022 đến tháng 05/2023 tại bệnh viện Đà Nẵng. Mức độ tổn thương trên hình ảnh học sọ não được đánh giá thông qua điểm pc-ASPECT. Kết cục chức năng được đánh giá theo modified Rankin scale (mRS) tại thời điểm ra viện và sau 3 tháng. Kết quả: Tuổi trung bình: 64 (58-68) tuổi. Giới nam: 66,7%. Điểm NIHSS lúc nhập viện 13 [7,75 - 18,5], điểm pc- ASPECT 8,5 [8-10]. Tỷ lệ bệnh nhân được tiêu sợi huyết 60,0%, can thiệp nội mạch (23,3%), kết hợp 16,7%. Thời gian cửa kim: 40 phút [29,5-70,25], thời gian cửa bẹn: 130 phút [111,5-147,5]. Tỉ lệ bệnh nhân biến chứng chảy máu não có triệu chứng 3,6% (pH1). Tỉ lệ kết cục tốt (mRS 0-2) tại thời điểm sau 3 tháng là 40%. Điểm NIHSS lúc nhập viện thấp, điểm GCS cao, điểm pc-ASPECT ≥8, không tắc động mạch thân nền là các yếu tố có liên quan đến kết cục chức năng tốt (mRS 0-2) sau 3 tháng. Kết luận: Điều trị tái tưới máu NMN tuần hoàn sau có kết cục thuận lợi trong nghiên cứu của chúng tôi còn thấp. Điểm NIHSS, điểm pc-ASPECT, tình trạng tắc động mạch thân nền là các yếu tố ảnh hưởng kết cục chức năng sau 3 tháng.To evaluate the effectiveness of reperfusion treatment in patients with posterior cerebral infarction and the relationship between clinical and paraclinical characteristics with the effectiveness of reperfusion treatment. Subjects and methods: A cross-sectional descriptive study on 30 patients with acute posterior cerebral infarction hospitalized from June 2022 to May 2023 at Da Nang hospital. The extent of infarct lesions on brain imaging was assessed by pc- ASPECT score. Functional outcome was assessed by modified Rankin scale score at 3 months. Results: Mean age 64 (58-68) years old. Male: 66.7%. NIHSS score at admission 13 [7.75-18.5], pc-ASPECT score 8.5 [8-10]. The proportion of patients receiving thrombolysis was 60.0%, endovascular intervention (23.3%), combined 16.7%. Door to needle time: 40 minutes [29.5-70.25], door to groin puncture time: 130 minutes [111.5-147.5]. The rate of patients with symptomatic cerebral hemorrhage is 3.6% (pH1). The good outcome rate (mRS 0-2) at 3 months was 40%. Low NIHSS score at admission, high GCS score, pc-ASPECT score ≥8, and no basilar artery occlusion are factors related to good functional outcome (mRS 0-2) after 3 months. Conclusion: Reperfusion treatment with posterior cerebral infarction has a low favorable outcome in our study. NIHSS score, pc-ASPECT score, basilar artery occlusion are factors that affect functional outcome after 3 months.

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