Phối hợp đa chuyên ngành trong điều trị đột quỵ chảy máu não do vỡ dị dạng động tĩnh mạch não tại Bệnh viện Trung ương quân đội 108=Multidisciplinary coordination in the treatment of intracranial hemorrhagic stroke due to ruptured cerebral arteriovenous malformation

0 Người đánh giá. Xếp hạng trung bình 0

Tác giả: Thuý Linh Nguyễn, Trọng Yên Nguyễn, Văn Tuyến Nguyễn, Đức Thao Tạ

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.305-311

Bộ sưu tập: Metadata

ID: 477898

Thêm vào giỏ

Đánh giá kết quả điều trị các bệnh nhân (BN) chảy máu não (CMN) do vỡ dị dạng thông động tĩnh mạch não (Arteriovenous malformations-AVM) và phân tích một số yếu tố ảnh hưởng đến kết quả điều trị. Đối tượng và phương pháp: Mô tả cắt ngang 59 BN được chẩn đoán và điều trị CMN do vỡ AVM ở Khoa Đột quỵ, BVTWQĐ 108 từ tháng 01/2023 – 06/ 2024. Kết quả: Tuổi trung bình (36±15,5)
Nam giới: 62,7%. Vị trí chảy máu não trên CT sọ ở thùy thái dương, chẩm, trán chiếm tỷ lệ cao. Phình mạch: 54,2% BN, số cuống mạch nuôi trung bình (1,85±1,04), Spetzler-Martin 1-2 (62,7%). Can thiệp nút AVM: 78% (nút kín hoàn toàn: 7,3%, kín một phần: 62,7%. Phẫu thuật đơn thuần: 3,4%, phẫu thuật kết hợp nút mạch: 18,6%. Biến chứng tắc mạch: 6,8%, chảy máu: 8,5%. Tỷ lệ nút kín ở nhóm kích thước AVM <
30 và chỉ có 1 nguồn nuôi cao hơn có ý nghĩa thống kê. Không thấy sự liên quan giữa 2 nhóm điểm Spetzler Martin và khả năng nút kín AVM. Kết luận: Việc lựa chọn phương pháp điều trị bằng nút mạch hay phẫu thuật hoặc hết hợp cả hai phương pháp cần dựa trên đặc điểm giải phẫu của khối AVM và cần có sự thảo luận của các bác sỹ chuyên ngành liên quan.Evaluate the results of patients with intracranial hemorrhage due to ruptured cerebral arteriovenous malformations (AVM) and analyze some factors affecting treatmen results. Methods: Cross-sectional study of 59 patients diagnosed and treated for intracra- nial hemorrhage due to ruptured cerebral arteriovenous malformations (AVM) at the Stroke Department, Hospital 108 from January 2023 to June 2024. Results: The average age of patients in the study was 36±15.5
Of which the majority are men, accounting for 62.7%. The location of hemorrhage on CT is in the temporal, occipital, and forehead lobes, accounting for a high proportion. Aneurysms were found in 54.2% of all patients, the average number of aneurysms was 1.85 ± 1.04, and Spetzler - Martin 1-2 had a high rate of 62.7%. AVM intervention accounts for 78%
Of which 37.3% are completely embolization, and 62.7% are partially embolization. Surgery alone is 3.4%, and surgery combined with embolization is 18.6%. Embolic complications occurred in 6.8%, bleeding in 8.5%. The rate of AVM was complete embolization in the group with AVM size <
30 and only one feeding source was statistically significantly higher. There was no correlation between the two groups of Spetzler Martin scores and the ability to close the AVM. Conclusion: The choice of treatment method with embolization or surgery or a combination of both methods should be based on the anatomical characteristics of the AVM and requires discussion with relevant specialized doctors.

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