Dự báo tổn thương mạch máu lớn bằng đánh giá van ở bệnh nhân nhồi máu não cấp=Prediction of large vessel occlusion by van assessment in patients with acute cerebral infarction

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Tác giả: Tâm Tính Hồ, Khánh Hoàng

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.69-76

Bộ sưu tập: Báo, Tạp chí

ID: 242222

Thêm vào giỏ

Determine the rate of positive VAN in predicting large vessel occlusion in patients with acute cerebral infarction. Survey the relationship between positive/negative VAN with Glasgow, NIHSS scale, cerebral vascular imaging and some risk factors. Method: Crosssectional description, convenient sample of acute cerebral infarction patients treated at the Stroke Center of Hue Central Hospital from April 2021 to July 2022. VAN (+) when there is paralysis plus one or two, three factors V, A or N (Vision, Aphasia, Neglect). VAN (-): no paralysis or no evidence of V, A or N disorder. CTA/DSA scan to determine the location of large vessel occlusion. Determine the relationship between VAN assessment with Glasgow, NIHSS scale, cerebral vascular imaging. Data processing using Excel 2017 and SPSS 22.0. Results: Clinically positive VAN in patients with acute cerebral infarction was 53.4%. VAN (+) had large vessel occlusion in 84.84% on CTA/DSA, while VAN (-) had no large vessel occlusion. VAN (+)/(-) had a difference between Glasgow ≤ 12 and 13 - 15 points, NIHSS <
6 and ≥ 6 points, age <
60 with p<
0.05 and no difference between the group with or without hypertension, diabetes, lipid disorders with p>
0.05. VAN had a sensitivity in diagnosing large cerebral vessel occlusion of 100.0%, specificity of 85.7%, positive prediction of 84.8% and negative prediction of 100.0%. Conclusion: VAN (+) 53.4% of which large vessel occlusion on CTA/DSA 84.84%. VAN (+) is valuable in determining large vessel occlusion in acute cerebral infarction with a sensitivity of 100%, specificity of 85.7%, positive prediction of 84.8% and negative prediction of 100.0% and is correlated with the levels of Glasgow and NIHSS scale. Larger sample size studies are needed to truly determine the value of VAN assessment.Xác định tỷ lệ VAN dương tính trong dự báo tắc mạch máu lớn ở bệnh nhân nhồi máu não cấp (NMNC). Khảo sát mối liên quan giữa VAN dương/âm tính với thang điểm Glasgow, NIHSS, hình ảnh học mạch máu não và một số yếu tố nguy cơ. Phương pháp: Mô tả cắt ngang, mẫu thuận tiện trên bệnh nhân NMNC điều trị tại Trung tâm Đột quỵ bệnh viện Trung ương Huế từ tháng 4/2021 đến tháng 7/2022. VAN (+) khi có liệt cộng với một hoặc hai, ba yếu tố V, A hoặc N (thị lực, mất ngôn ngữ, lãng quên). VAN (-): không có liệt hoặc không có bằng chứng về rối loạn V, A hoặc N. Chụp CTA/DSA để xác định vị trí tắc mạch mạch lớn. Xác định mối liên quan giữa đánh VAN với thang điểm Glasgow, NIHSS, hình ảnh học mạch não. Xử lý số liệu bằng Excel 2017 và SPSS 22.0. Kết quả: VAN dương tính trên lâm sàng ở bệnh nhân nhồi máu não cấp là 53,4%. VAN (+) có tắc mạch lớn chiếm 84,84% trên CTA/DSA, còn VAN (-) thì không trường hợp nào tắc mạch lớn. VAN (+)/(-) có sự khác biệt giữa Glasgow ≤ 12 và 13-15 điểm, NIHSS <
6 và ≥ 6 điểm, tuổi <
60 với p<
0,05 và không có sự khác biệt ở nhóm có hay không có tăng huyết áp, đái tháo đường, rối loạn lipid với p >
0,05. VAN có độ nhạy trong chẩn đoán tắc mạch máu não lớn là 100,0%, độ đặc hiệu 85,7%, dự báo dương tính 84,8% và dự báo âm tính 100,0%. Kết luận: VAN (+) 53,4% trong đó tắc mạch lớn trên CTA/DSA 84,84%. VAN (+) có giá trị trong xác định tắc mạch lớn trong nhồi máu não cấp với độ nhạy 100%, độ đặc hiệu 85,7%, dự báo dương tính 84,8% và dự báo âm tính 100,0% và có mối liên quan với các mức của thang điểm Glasgow và NIHSS. Cần nghiên cứu cở mẫu lớn hơn để xác định đích thực giá trị của đánh giá VAN.

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