Nghiên cứu đặc điểm lâm sàng, một số yếu tố liên quan và kết quả điều trị can thiệp nội mạch vỡ phình động mạch não ở bệnh nhân chảy máu dưới nhện=Research on clinical features, relevant factors and outcome of endovascular intervention for ruptured cerebral aneurysm with subarachnoid hemorrhage

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Tác giả: Đình Toàn Nguyễn, Đăng Nhật Võ

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.277-285

Bộ sưu tập: Metadata

ID: 477891

Thêm vào giỏ

Chảy máu dưới nhện (CMDN) là một trong những dạng của đột quỵ, gây tử vong và khuyết tật nặng nề. Nguyên nhân thường gặp do vỡ phình động mạch não, điều trị bằng can thiệp nội mạch là phương pháp có kết quả tối ưu, nhưng kết quả còn nhiều yếu tố ảnh hưởng. Mục tiêu: Khảo sát đặc điểm lâm sàng và hình ảnh học của túi phình động mạch não vỡ gây CMDN
Đánh giá kết quả điều trị can thiệp nội mạch túi phình động mạch não vỡ gây CMDN và các yếu tố liên quan. Đối tượng và phương pháp: Nghiên cứu mô tả cắt ngang có phân tích trên bệnh nhân CMDN ≥ 18 tuổi do vỡ phình động mạch não được điều trị can thiệp nội mạch nút túi phình bằng vòng xoắn kim loại tại khoa Đột quỵ Bệnh viện Đà Nẵng trong thời gian từ tháng 11 năm 2021 đến hết tháng 5 năm 2023. Kết quả: Phân độ lâm sàng theo Hunt-Hess chủ yếu là độ 1, 2 với tỷ lệ 72,2%, nhóm phân loại Fisher 3,4 chiếm 80,6%. Tỷ lệ tử vong tại thời điểm ra viện: 11,1%, kết cục tốt (mRS 0-2): 55,6%, khuyết tật - tử vong (mRS 3-6): 44,4%
Sau 3 tháng tỷ lệ có kết cục tốt chiếm 77,8%, tỷ lệ khuyết tật: 11,1%. Các yếu tố dự đoán kết quả điều trị trong mô hình của chúng tôi là phân độ Hunt - Hess lúc nhập viện, thời gian từ khởi phát đến lúc can thiệp làm tắc túi phình và mức độ lấp đầy túi phình khi can thiệp với p <
0,05. Kết luận: Can thiệp nội mạch sớm và lấp đầy túi phình là lựa chọn hiệu quả trong điều trị CMDN do vỡ phình động mạch não.Subarachnoid hemorrhage is one of the forms of stroke, causing death and severe disability. The cause of brain aneurysm rupture is very common, endovascular intervention is an optimal method, however the outcome has been restricted by different factors. Objective: To survey the clinical and morphological features of ruptured cerebral aneurysms causing subarachnoid hemorrhage
To evaluate the outcome of endovascular treatment of ruptured cerebral aneurysms causing subarachnoid hemorrhage and related factors. Research subjects and methodology: Crosssectional descriptive study with analysis on patients ≥ 18 years old with subarachnoid hemorrhage due to ruptured cerebral aneurysm being treated with endovascular intervention to plug the aneurysm with a metal coil at the Stroke Department of Da Nang Hospital from November 2021 to the end of May 2023. Results: Clinical grading according to Hunt - Hess is mainly grade 1, 2 with a rate of 72.2%, Fisher classification group 3,4 accounts for 80.6%. Mortality rate at hospital discharge was 11.1%, good outcome (mRS 0-2) was 55.6%, disability-death (mRS 3-6) was 44.4%
After 3 months, the rate of good outcome was 77.8%, the rate of disability was 11.1%. Factors used for predicting treatment outcomes in our model are Hunt - Hess scale at admission, the time from the onset to the intervention to and the degree of aneurysm filling during intervention with p <
0.05. Conclusion: Early endovascular intervention and aneurysm filling is an effective option in the treatment of subarachnoid hemorrhage due to ruptured cerebral aneurysm.

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