Đặc điểm lâm sàng và kết cục ngắn hạn của bệnh nhân nhồi máu não nhẹ tuần hoàn trước=Clinical characteristics and short-term outcomes among patients with mild ischemic stroke of anterior circulation

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Tác giả: Bá Thắng Nguyễn, Phước Tuấn Phạm, Huy Thái

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.23-33

Bộ sưu tập: Metadata

ID: 242227

Thêm vào giỏ

Mô tả đặc điểm lâm sàng, nguyên nhân của NMN nhẹ và đánh giá kết cục trong 90 ngày và các yếu tố liên quan ở BN NMN nhẹ. Đối tượng và phương pháp: Nghiên cứu (NC) mô tả, tiến cứu 69 BN NMN nhẹ (NIHSS ≤ 5 điểm) tuần hoàn trước, điều trị tại Đơn vị Đột quỵ, Bệnh Viện Đại Học Y Dược Thành Phố Hồ Chí Minh từ 10/2022 đến 10/2023. Kết cục chức năng được đánh giá theo điểm mRS tại các thời điểm vào viện, ra viện, 30 ngày và 90 ngày. Kết quả: NIHSS trung bình vào viện: 2,6±1,5, phổ biến nhất là liệt mặt, yếu chi và rối loạn phát âm. Khiếm khuyết thần kinh: 23,2%
NIHSS tăng  4 điểm trong 24 giờ đầu: 14,4%
xơ vữa động mạch (XVĐM) lớn: 31,9%
. tiêu sợi huyết (TSH) đường tĩnh mạch: 5,8%. Tại thời điểm 90 ngày: mRS 2 – 6 (33,3%), tỷ lệ tái phát tích lũy 7,2%)
không ghi nhận tử vong hay biến cố mạch máu khác. Yếu tố tiên lượng kết cục chức năng không tốt gồm: rung nhĩ, hẹp động mạch nội sọ (ĐMNS) có ý nghĩa và NIHSS tăng  4 điểm trong 24 giờ đầu. Kết luận: Bệnh nhân đột quỵ nhẹ vẫn có nguy cơ trở nặng và có kết cục xấu, đặc biệt ở nhóm có rung nhĩ, hẹp ĐMNS có ý nghĩa hoặc có triệu chứng thần kinh tiến triển nặng trong 24 giờ đầu.To describe clinical characteristics and causes of mild stroke and evaluate outcomes within 90 days and related factors in mild ischemic stroke patients. Methods: A descriptive, prospective study on 69 patients with mild stroke of the anterior circulatory (NIHSS ≤ 5 points), treated at the Stroke Unit, University Hospital of Medicine and Pharmacy, Ho Chi Minh City from October 2022 to October 2023. Results: The average NIHSS score at admission was 2.6± 1.5. The most common symptoms: facial paralysis, limb weakness, dysphonia. Neurological defects causing disability accounted for 23.2%
14.4% had NIHSS score increase of ≥ 4 points within the first 24 hours. The most common cause was large artery atherosclerosis (31.9%). Intravenous thrombolytic therapy was prescribed for 5.8% cases. At 90 days: poor outcome (mRS 2 - 6) occurred in 33.3%, the cumulative recurrence rate was 7.2%
no one died or had other vascular events. Predictive factors for poor functional outcome include: atrial fibrillation, significant intracranial artery stenosis (ICAS) and increase in NIHSS ≥ 4 points within the first 24 hours. Conclusion: It is necessary to improve patient education for mild stroke, especially in groups with atrial fibrillation, significant ICAS or progressive deterioration.

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