Tần suất suy thượng thận thứ phát giai đoạn 06 tháng sau chấn thương sọ não / Tần suất tái phát của ung thư vòi tử cung tại Bệnh viện Từ Dũ

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Tác giả: Lâm Thương Bùi, Hữu Thịnh Cao, Minh Mẫn Dương, Khánh Duy Nguyễn, Thy Khuê Nguyễn, Hữu Hên Phan, Minh Lộc Trần, Minh Tuấn Võ, Thanh Nhân Võ

Ngôn ngữ: vie

Ký hiệu phân loại: 610616.994 Medicine and health

Thông tin xuất bản: Y học thực hành, Tạp chí Y học Việt Nam (Tổng hội Y học Việt Nam), 20132023

Mô tả vật lý: 21-26, 321-327

Bộ sưu tập: Metadata

ID: 482928

Thêm vào giỏ

Objective: Determine the prevalence of secondary adrenal failure, and other factors related to secondary adrenal failure in patients with traumatic brain injury after 06 months period Methods: crosssectional description. Implementation period from 04/2011- 04/2012 at the Department of Neurosurgery Care Unit and Outpatient Department - Cho Ray Hospital. Traumatic brain injury patients with Glasgow at admission 13 points and brain damage on CT scan were evaluated the function of pituitary-adrenal axis after 06 months. Pituitary - adrenal axis failure was defined as synacthene 250mcg test: blood cortisol 30 minutes after injection ACTH 200 ng/ml combination with low ACTH or normal range. Results: 156 patients in the 06-month follow-up, 53 died patients accounted for 33.9 percent. 88 survived patients returned for study, males accounted for 89.8 percent. Average age of patients was 31.1 percent 13.7 (minimum age 15, maximum 71). 73 percent of patients with Glasgow at admission 9 points Mean time for reexamination after traumatic brain injury: 5.8 percent 1.1 months. There are seven patients with secondary adrenal failure, accounting for 8 percent. Frequency of secondary adrenal failure in Glasgow group 9 points higher than the Glasgow group 9-13 (9.4 percent vs. 4.2 percent). No factors significantly associated with secondary adrenal failure. However, all seven patients with secondary adrenal failure were severe disability and sequelae were male patients. Cut off point of cortisol level in secondary adrenal failure diagnosis was 93.5 ng/ml with a sensitivity and specificity of 71.4 percent and 75.3 percent respectively. The area under the curve was 0.704. Conclusion: The prevalence of secondaryadrenal failure in the period of 06 months after traumatic brain injury was 8 percent. Frequency of secondary adrenal failure in Glasgow group 9 points higher than the Glasgow group 9-13. No factors significantly associated with secondary adrenal failure. All 7 patients with secondary adrenal failure were severe disability and sequelae were male patients.Xác định tần suất tái phát và các yếu tố liên quan đến tái phát của UTVTC tại Bệnh viện Từ Dũ. Phương pháp Nghiên cứu đoàn hệ hồi cứu trên 47 trường hợp có kết quả giải phẫu bệnh là UTVTC tại Bệnh viện Từ Dũ từ 01/2015 - 07/2022. Kết quả Thời gian theo dõi có trung vị là 40 tháng (phạm vi, 7 - 96 tháng). Nghiên cứu ghi nhận có 8 người bệnh (17,0%) tái phát. Tần suất tái phát tích lũy của UTVTC tại thời điểm 12 tháng là 4,4% (KTC 95% 1,12 - 16,45), 24 tháng là 9,1% (KTC 95% 3,52 - 22,5), 36 tháng là 14,9% (KTC95% 6,92 - 30,41), 48 tháng là 19,3% (KTC 95% 9,35 - 37,24) và 60 tháng là 25,7% (KTC 95% 12,68 - 47,88). Trong mô hình phân tích đa biến, những yếu tố liên quan đến tái phát của UTVTC được ghi nhận gồm tăng CA 125 trước điều trị (<
35 U/mL so với ≥ 35 U/mL, HR 36,9, KTC 95% 1,47 - 921,37), giai đoạn bệnh tiến triển (giai đoạn I - II so với giai đoạn III, HR 6,61, KTC 95% 1,18 - 36,93) và phẫu thuật giảm khối không đạt được tối ưu (bệnh tồn dư ≤ 1 cm so với bệnh tồn dư >
1 cm, HR 7,52, KTC 95% 1,47 - 38,49). Kết luận Tần suất tái phát chung của UTVTC tại Bệnh viện Từ Dũ là 17%. Tăng CA 125 trước điều trị, giai đoạn bệnh tiến triển và phẫu thuật giảm khối không đạt được tối ưu là những yếu tố nguy cơ chính liên quan đến tái phát của UTVTC.

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