Kết quả điều trị và các yếu tố tiên lượng ở bệnh nhân nhồi máu não cấp do tắc mạch lớn có lõi nhồi máu lớn được lấy huyết khối cơ học=Treatment outcomes and prognostic factors in acute ischemic stroke patients with large core infarcts undergoing mechanical thrombectomy

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Tác giả: Quang Toàn Lê, Ngọc Hòa Nguyễn, Thanh Long Nguyễn

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.189-196

Bộ sưu tập: Metadata

ID: 477875

Thêm vào giỏ

Đánh giá kết quả điều trị và các yếu tố tiên lượng kết quả điều trị lấy huyết khối cơ học ở các bệnh nhân nhồi máu não cấp do tắc mạch lớn có ASPECTS dưới 6 điểm. Đối tượng và phương pháp: Nghiên cứu mô tả, theo dõi dọc 28 bệnh nhân nhồi máu não cấp do tắc động mạch lớn tuần hoàn trước có lõi lớn, được lấy huyết khối cơ học trong vòng 6 giờ tại Bệnh viện Hữu nghị Đa khoa Nghệ An từ tháng 03/2022 đến tháng 03/2024. Kết quả: Tỷ lệ tái thông tốt (TICI 2b-3) đạt 85,7%, kết quả tốt (mRS 0-3) sau 3 tháng là 35,7%, tỉ lệ tử vong sau 3 tháng là 21,4%
các yếu tố tuổi, NIHSS vào viện, điểm thành phần M4 đến M6 của thang điểm ASPECTS được đánh giá theo tỷ lệ tỷ trọng tối ưu và có phẫu thuật giải áp có giá trị tiên lượng cho kết quả hồi phục sau 3 tháng. Kết luận: Phương pháp điều trị lấy huyết khối cơ học đạt tỉ lệ tái thông tốt cao và có thể có kết quả phục hồi tốt ở nhóm bệnh nhân nhất định, một số yếu tố có giá trị tiên lượng kết quả điều trị nên được cân nhắc khi chỉ định lấy huyết khối cơ học.To evaluate treatment outcomes and prognostic factors in patients with acute ischemic stroke and large core infarcts (ASPECTS <
6) and underwent mechanical thrombectomy. Subjects and methods: A descriptive follow-up of 28 patients with acute ischemic stroke due to large vessel occlusion who had large core infarcts and underwent mechanical thrombectomy within 6 hours at Nghe An Friendship General Hospital, from March 2022 to March 2024. Results: The rate of successful reperfusion (TICI 2b-3) was 85.7%. Good functional outcomes (mRS 0-3) at 3 months were observed in 35.7%. The 3-month mortality rate was 21.4%. Prognostic factors for functional outcomes included age, NIHSS at admission, ASPECTS component scores (M4 to M6) evaluated on optimal attenuation ratio, and decompressive craniectomy. Conclusions: Mechanical thrombectomy achieved a high rate of successful reperfusion and could lead to favorable outcomes in specific patient groups. Some prognostic factors influenced outcomes and should be considered when deciding on mechanical thrombectomy.

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