Dự hậu chảy máu dưới nhện do vỡ phình động mạch não được điều trị bằng can thiệp nội mạch trong 24 giờ đầu=The outcome of aneurysmal subarachnoid hemorrhage treated by endovascular intervention within 24 hours

0 Người đánh giá. Xếp hạng trung bình 0

Tác giả: Minh Đăng Lê, Quang Trí Nguyễn, Vương Khoa Tạ, Thanh Vũ Trần, Anh Nhị Vũ

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.299-304

Bộ sưu tập: Metadata

ID: 477895

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The time for treatment of etiology to gain optimal outcome in aneurysmal subarachnoid hemorrhage is a matter of debate, in which treatment within 24 hours of onset is the most concerned. Objective: To evaluate the correlation between endovascular intervention to treat of etiology within 24 hours with outcome of aneurysmal subarachnoid hemorrhage. Subject and method: Longitudinal prospective study was conducted in 108 patients with aneurysmal subarachnoid hemorrhage who were treated for embolization of cerebral aneurysms by endovascular coiling, including 53 patients treated within 24 hours and 55 patients treated after 24 hours, at People’s Hospital 115 from October 2018 to April 2021. Outcome was measured by the modified Rankin Scale (mRS). Results: The rates of mortality and morbidity (mRS 3-6) was significant lower in the group treated within 24 hours than the group treated after 24 hours at 1 year after discharge (5.7% vs. 21.8% respectively, P=0.015). Multivariable regression analysis showed that endovascular intervention within 24 hours was the significant associated factor with improved clinical outcomes at 1 year after discharge (RR 3.25
95% CI 1.03-10.2
P=0.044). Conclusion: Endovascular intervention to treat of etiology within 24 hours of onset is independent predictor of good outcome in aneurysmal subarachnoid hemorrhage.Thời điểm điều trị căn nguyên mang lại dự hậu tối ưu trong chảy máu dưới nhện do vỡ phình động mạch não còn tranh luận, trong đó điều trị trong vòng 24 giờ đầu kể từ thời điểm khởi phát bệnh được quan tâm nhiều nhất. Mục tiêu: Đánh giá mối tương quan giữa can thiệp nội mạch điều trị căn nguyên trong vòng 24 giờ đầu với dự hậu chảy máu dưới nhện do vỡ phình động mạch não. Đối tượng và phương pháp: Nghiên cứu tiến cứu dọc trên 108 bệnh nhân chảy máu dưới nhện do vỡ phình động mạch não được can thiệp nội mạch nút coil, bao gồm 53 bệnh nhân can thiệp trong vòng 24 giờ đầu và 55 bệnh nhân can thiệp sau 24 giờ, tại Bệnh viện Nhân Dân 115 từ 10/2018 đến 4/2021. Dự hậu đánh giá bằng thang điểm Rankin hiệu chỉnh (mRS: modified Rankin Scale). Kết quả: Tỉ lệ tử vong và khuyết tật (mRS 3-6) tại thời điểm 1 năm thấp hơn có ý nghĩa ở nhóm can thiệp trong vòng 24 giờ đầu so với nhóm can thiệp sau 24 giờ (5,7% so với 21,8%, P=0,015). Can thiệp trong vòng 24 giờ đầu liên quan có ý nghĩa với cải thiện dự hậu tại thời điểm 1 năm (RR 3,25
KTC 95% 1,03-10,2
P=0,044) theo phân tích đa biến. Kết luận: Can thiệp nội mạch điều trị căn nguyên trong vòng 24 giờ đầu kể từ thời điểm khởi phát bệnh là yếu tố tiên lượng độc lập của dự hậu khả quan trong xuất huyết dưới nhện do vỡ phình động mạch não.

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