Đặc điểm lâm sàng và yếu tố nguy cơ viêm phổi thở máy ở bệnh nhân đột quỵ chảy máu có giãn não thất cấp được đặt dẫn lưu não thất mở=The clinical and paraclinical characteristics, factors related to ventilator associated pneumonia in patients with hemorrhagic stroke and acute ventricular dilatation undergoing external ventricular drainage

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Tác giả: Chi Viện Lê, Thị Cúc Nguyễn, Thị Loan Nguyễn, Văn Tuyến Nguyễn

Ngôn ngữ: vie

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

Mô tả vật lý: tr.99-107

Bộ sưu tập: Metadata

ID: 242218

Thêm vào giỏ

Nhận xét đặc điểm lâm sàng, cận lâm sàng và các yếu tố liên quan tới viêm phổi thở máy ở bệnh nhân (BN) đột quỵ chảy máu não (ĐQCMN) có giãn não thất cấp được đặt dẫn lưu não thất mở tại khoa Đột quỵ, BVTWQĐ 108. Đối tượng và phương pháp: 66 BN ĐQCMN giãn não thất cấp được đặt dẫn lưu não thất mở, trên 15 tuổi
được đặt nội khí quản hoặc thở máy qua mở khí quản ≥ 48h, trong thời gian từ tháng 1/ 2022- 1/2024. Kết quả: tỷ lệ viêm phổi thở máy (43,93%), vi khuẩn thường gặp nhất là acinetobacter baumannii (37,93%). BN viêm phổi thở máy có độ tuổi cao hơn, điểm glasgow thấp hơn, điểm NIHSS cao hơn nhóm không viêm phổi thở máy, (p>
0,05). Thời gian thở máy xâm nhập, tỷ lệ mở khí quản, thời gian nằm viện của nhóm BN viêm phổi thở máy cao hơn nhóm không viêm phổi (p<
0,05). Các yếu tố nguy cơ liên quan độc lập với viêm não thất bao gồm điểm Glasgow  8 và , thời gian lưu dẫn lưu não thất trên 10 ngày. Kết luận: Bệnh nhân có điểm Glasgow  8 tại thời điểm nhập viện và thời gian lưu dẫn lưu não thất trên 10 ngày là yếu tố nguy cơ độc lập với viêm phổi thở máy ở bệnh nhân đột quỵ chảy máu có giãn não thất cấp được đặt dẫn lưu não thất mở.To review the clinical and paraclinical characteristics and factors related to ventilator-associated pneumonia in patients with hemorrhagic stroke and acute ventricular dilatation undergoing external ventricular drainage at the Department of Stroke, Millitary Central Hospital 108. Subjects and methods: 66 patients with acute intracerebral haemorrhage expanding intraventricular who were indicated with external ventricular drainage, over 15 years old
were intubated or mechanically ventilated via tracheostomy for ≥ 48 hours. The study was conducted at the Stroke Department - National Hospital 108 during the period from January 2022 to January 2024. Results: Rate of ventilator-associated pneumonia (43.93%), the most common bacteria is Acinetobacter baumannii (37.93%). Patients with mechanically ventilated pneumonia were older, had lower Glasgow scores, and higher NIHSS scores than the group without mechanically ventilated pneumonia (the difference was not statistically significant with p>
0.05). The time of invasive mechanical ventilation, tracheostomy rate, and hospital length of patients with pneumonia on ventilators were higher than those without pneumonia (the difference was statistically significant with p<
0.05). Risk factors independently associated with ventriculitis include Glasgow score  8 and, ventricular drainage duration over 10 days. Conclusion: Glasgow Score ≤ 8 on admission and duration of ventricular drainage more than 10 days are independent risk factors for ventilator-associated pneumonia in hemorrhagic stroke patients with acute ventriculomegaly who have an external ventricular Drainage.

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