Nghiên cứu chuyển dạng chảy máu bằng thang điểm HTI và yếu tố nguy cơ liên quan ở bệnh nhân nhồi máu não cấp do tắc động mạch não giữa=Study on hemorrhagic transformation using HTI scale and related risk factors in patients with acute cerebral infarction due to middle cerebral artery occlusion

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Tác giả: Khánh Hoàng, Thị Vy 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.259-266

Bộ sưu tập: Metadata

ID: 477887

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Đánh giá chuyển dạng chảy máu (CDCM) bằng thang điểm HTI trong 14 ngày đầu nhồi máu não cấp (NMNC) do tắc động mạch não giữa (ĐMNG). Xác định yếu tố nguy cơ liên quan đến CDCM. Phương pháp: Nghiên cứu mô tả cắt ngang 120 bệnh nhân (BN) được chẩn đoán NMNC do tắc ĐMNG tại Trung tâm đột quỵ Bệnh viện Trung ương Huế từ tháng 5/2021- 6/2023. Khám xác định yếu tố nguy cơ đột quỵ, khảo sát thang điểm HTI, phương thức điều trị và theo dõi trong vòng 14 ngày kể từ khi khởi phát triệu chứng. Nếu có dấu hiệu đau đầu, liệt nặng hơn hoặc và là có thay đổi tình trạng ý thức …thì chụp CLVT/CHT sọ não ngay để xác định có biến chứng chảy máu hay không. Phân loại CDCM theo ECASS I và CDCM trên lâm sàng theo NINDS. Xử lý bằng SPSS 22.0. Kết quả: 32,5% BN CDCM trong 14 ngày đầu. Không triệu chứng 91,67%
có triệu chứng 8,33%. Triệu chứng gợi ý là: đau đầu, liệt nặng hơn hay giảm tri giác. Yếu tố nguy cơ độc lập dự báo CDCM là huyết áp tâm thu, mức glucose máu, điểm NIHSS, điểm ASPECTS, phương pháp lấy huyết khối nội mạch. Điểm cắt HTI 2 có độ nhạy 82,1%, độ đặc hiệu 82,7% trong dự đoán nguy cơ CDCM. Kết luận: CDCM chiếm 32,5% trong đó có triệu chứng chỉ 8,33%. HTI ≥2, huyết áp tâm thu, mức glucose máu, điểm NIHSS, ASPECTS, phương pháp lấy huyết khối nội mạch có giá trị dự đoán nguy cơ CDCM trong nhồi máu não cấp.Evaluate hemorrhagic transformation using the HTI scale in the first 14 days of acute cerebral infarction due to middle cerebral artery occlusion. Identify risk factors associated with hemorrhagic transformation. Method: Using a cross-sectional descriptive study method. 120 patients were diagnosed with acute cerebral infarction due to middle cerebral artery occlusion at the Stroke Center of Hue Central Hospital from May 2021 to June 2023. Examine to determine stroke risk factors, survey the HTI scale, treatment methods and be monitored within 14 days from the onset of symptoms. If there are signs of headache, worsening paralysis or changes in consciousness... then immediately perform a CT scan/brain MRI to determine whether there are hemorrhagic complications or not. Classify hemorrhagic transformation according to ECASS I and clinical hemorrhagic transformation according to NINDS. Processed using SPSS 22.0. Results: 32.5% of patients had hemorrhagic transformation within the first 14 days. Asymptomatic 91.67%
symptomatic only 8.33% of whom had suggestive symptoms such as headache, worsening paralysis or decreased consciousness. Independent risk factors predicting hemorrhagic transformation were systolic blood pressure, blood glucose level, NIHSS, ASPECTS score, and endovascular thrombectomy. The HTI score with a cutoff of 2 had a sensitivity of 82.1% and a specificity of 82.7% in predicting the risk of hemorrhagic transformation. Conclusion: Hemorrhagic transformation accounted for 32.5%, of which only 8.33% were symptomatic. HTI ≥2, systolic blood pressure, blood glucose level, NIHSS, ASPECTS score, and endovascular thrombectomy were valuable in predicting the risk of hemorrhagic transformation of acute cerebral infarction.

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