Đặc điểm lâm sàng và các yếu tố liên quan đến quả điều trị ở bệnh nhân chảy máu dưới nhện do vỡ phình mạch não

0 Người đánh giá. Xếp hạng trung bình 0

Tác giả: Thị Hải Hà Đinh, Thị Cúc Nguyễn, Thúy Linh Nguyễn, Văn Tuyến Nguyễn, Tiến Tuyên Phạm, Đức Thao Tạ

Ngôn ngữ: vie

Ký hiệu phân loại: 616.81 *Cerebrovascular diseases

Thông tin xuất bản: Tạp chí Y học Việt Nam (Tổng hội Y học Việt Nam), 2022

Mô tả vật lý: 246-253

Bộ sưu tập: Metadata

ID: 500568

Thêm vào giỏ

Đánh giá đặc điểm lâm sàng, cận lâm sàng và các yếu tố ảnh hưởng đến kết cục xấu sau 6 tháng ở BN CMDN do vỡ phình mạch não. Đối tượng và phương pháp: 100 BN CMDN do vỡ phình mạch não tại Khoa Đột quỵ BVTWQĐ 108 từ 01/2021 - 01/2022. Thu nhập dữ liệu về lâm sàng, cận lâm sàng trong quá trình điều trị, so sánh các dữ liệu này giữa hai nhóm kết quả tốt (mRS 0-3) và kết quả kém (mRS 4-6) sau 6 tháng. Các yếu tố được phân tích hồi quy logistic. Kết quả: Khởi phát đột ngột 87 %, Đau đầu 90%. Có 67% kết cục tốt và 33% kết cục kém. Các yếu tố liên quan đến cục kém: Tiền sử đái tháo đường (OR: 0.128
95% CI: 0.026-0.731), co giật (OR: 0.082
95% CI: 0.017-0.407), rối loạn cơ tròn (OR: 0.098
95% CI: 0.029-0.334), rối loạn ý thức khi khởi phát (OR: 0.043
95% CI: 0.012-0.156). Điểm Glasgow (OR: 0.230
95% CI: 0.132-0.401), Hunt-Hess (OR: 25,13
95% CI: 7,62-82,84), WFNS (OR: 3,092
95% CI: 2,011-4,74) khi nhập viện. Mức độ chảy máu: điểm Fisher (OR: 35
95% CI: 4,51-271,13), máu tụ nhu mô (OR: 0.161
95% CI: 0.05-0.516), máu trong não thất (điểm Graeb) (OR:2,95
95% CI: 1,39-6,25), nhiệt độ cao nhất (OR:3,18
95% CI: 1,91-5,29), viêm phổi, (OR: 0.054
95% CI: 0.011-0.26), thiếu máu não muộn (DCI) (OR: 0.068
95% CI: 0.024-0.191). Kết luận: Khởi phát đột ngột và đau đầu là triệu chứng thường gặp nhất, các yếu tố liên quan đến kết quả điều trị gồm: Đái tháo đường, co giật, rối loạn cơ tròn, rối loạn ý thức khi khởi phát, điểm Glasgow, Hunt-Hess, WFNS. Fisher, có máu tụ, mức độ máu trong não thất, điểm Graeb, nhiệt độ cao, viêm phổi, thiếu máu não muộn.To evaluate the clinical and laboratory characteristics and factors affecting the poor outcome after 6 months in patients with CKD due to ruptured cerebral aneurysm. Subjects and methods: 100 patients with cerebral palsy due to ruptured brain aneurysm at the Stroke Department, National Hospital 108 from 01/2021 - 01/2022. Collect clinical, laboratory data during treatment, compare these data between two groups with good outcome (mRS 0-3) and poor outcome (mRS 4-6) after 6 months. The factors were analyzed by logistic regression. Results: Sudden onset 87%, Headache 90%. There were 67% good outcomes and 33% poor outcomes. Factors associated with poor clots: History of diabetes (OR: 0.128
95% CI: 0.026-0.731), seizures (OR: 0.082
95% CI: 0.017-0.407), circular muscle disorder (OR: 0.082
95% CI: 0.017-0.407). 0.098
95% CI: 0.029-0.334), disturbance of consciousness at onset (OR: 0.043
95% CI: 0.012-0.156). Glasgow score (OR: 0.230
95% CI: 0.132-0.401), Hunt-Hess (OR: 25.13
95% CI: 7.62-82.84), WFNS (OR: 3.092
95% CI: 2.011) -4.74) on admission. Degree of bleeding: Fisher score (OR: 35
95% CI: 4.51-271.13), parenchymal hematoma (OR: 0.161
95% CI: 0.05-0.516), intraventricular blood (Graeb score) (OR: 2.95
95% CI: 1.39-6.25), highest temperature (OR: 3.18
95% CI: 1.91-5.29), pneumonia, (OR: 0.054
95% CI: 0.011-0.26), late cerebral ischemia (DCI) (OR: 0.068
95% CI: 0.024-0.191). Conclusion: Sudden onset and headache are the most common symptoms, factors related to treatment outcome include: Diabetes mellitus, convulsions, circular muscle disorder, disturbance of consciousness at onset, score Glasgow, Hunt-Hess, WFNS. Fisher, hematoma, intraventricular blood level, Graeb score, high temperature, pneumonia, late cerebral ischemia.

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