581
NHN XÉT TRIU CHNG VÀ CÁC YU T LIÊN QUAN BNH NHÂN TAI
BIN MU TR TI KHOA THN KINH BNH VIN
THANH NHÀN
Phan Th i, Nguyn Th Anh
tháng 10/2010.
T khóa: Tai bin mch máu não tái phát
SUMMARY
COMMENT ABOUT SYMPTOMS AND RELATED FACTORS IN RECURRENCE
STROKE PATIENS AT NEUROLOGY DEPARTMENT OF THANH NHAN HOSPITAL
Subject and methods: We applied prospective study method on 65 recurrence stroke
patients at Neurology Department of Thanh Nhan hospital from January 2010 to October 2010.
Results: Symptoms:Disconciousness acquired 60%, Among coma 21,54%, confusion
38,46%. Paralysis 100%, Among hemiplegia coordinate with paralysis of face 84,62%. diplegia
15,38%. Hemisensory loss 20%, sphinester disorder 36,92, decubitus ulcer 29,23%. The diseases
come with stroke: pneumonia 72,31%, diabetes 41,54%, deformed joints 36,92%, heart failure
21,54%, renal failure 16,92%, gout 7,69%. In awareness as well as in the rate of decubitus ulcer,
there are some differences when patiens are admitted to and discharged from hospital. Clinical
symptoms: Cerebral haemorrhage (20%), multiple cerebral infarction (72,3%), large cerebral
infarction (7,69%), injured heart-lung X-ray (69,23%), ECG changes 81.54%. Lipid metabolism
disorders (64,62%), increase cholesteron (47,69%), increase triglycerid (56,92%), increase
triglycerid as well as cholesteron (35,38%), increase glucoza (46,15%), electrolyte disorders
(30,77%). Increasing HbA1C at diabetes patiens (100%), average 8,104 ± 1,551%. Increase
leucocyte (72,31%), decrease erythrocyte (21,54%). Some relevant factors: The older the
patiens are, the more recurrence strokes they can get. High blood pressure (100%), Lipid
metabolism disorders (64,62%), diabetes (41,54%). The more risk factors are combinated, the
heavier and more complicated recurrence stroke can get.
Key words: Recurrence stroke
Tai bin mch máu não (TBMMN) là nhóm bnh hay gp i cao tui, nó luôn mang
tính thi s vì tn só mc bnh trong cng rt cao, bnh cnh lâm sàng nng n, t l t
582
ng tàn tt nhiu, và chi phí y t xã hi rt ln. Tai bin mch máu não tái
phát hay gp và là mt yu t ng xu. Bn thân nhi b tai bin mch máu não
ln nhiu yu t a tai bin mch máu não tái phát.
1/2010
-
- C
- C
n kinh:
- Bm Glasgow.
- ISH (2003)
-
1999
Các xét nghim lâm sàng:
-
-
- Chp Xquang tim ph c thc hin ti khoa ch nh Bnh vin Thanh
Nhàn
- Thanh Nhàn
2.3. Tp hp và x lý s liu ng kê y hc.
3.1.
583
Nam
N
n
%
n
%
40-49
2
3,08
1
1,54
50-59
2
3,08
3
4,62
60-69
9
13,85
10
15,38
70-79
9
13,85
12
18,46
80-89
7
10,77
10
15,38
29
44,62
36
55,38
.
ng 3.2.
-
1
2
3
4
5
6
7
8
9
n
12
15
16
8
2
3
2
3
2
2
65
%
18,5
23,1
24,6
12,3
3,1
4,6
3,1
4,6
3,1
3,1
100
-
3.3.
n
%
4
6,15
11
16,92
13
20,0
37
56,92
65
100,0
3.4.
n
%
65
100,0
26
40,0
Hôn mê
14
21,54
25
38,46
cùng bên
55
84,62
10
15,38
13
20,0
28
43,08
24
36,92
19
29,23
3.5.
n
%
47
72,31
Suy thân
11
16,92
Suy tim
14
21,54
27
41,54
Gút
5
7,69
24
36,92
584
3.6. Các t
n
%
31
47,69
37
56,92
23
35,38
30
46,15
1
1,54
16
24,62
14
21,54
-MB
8
12,31
20
30,77
-
- S
3.7. MNTP
n
%
47/65
72,31
14/65
21,54
53/65
81,54
47/65
72,31
27/27
100.0
n
%
13
20
47
72,30
5
7,69
3.9.
n
%
65
100,0
27
41,54
42
64,62
gut
5
7,69
5
7,69
4
6,15
3.10.
n
%
20
30.77
THA+RLCHLP
24
36.92
9
13.84
THA+GUT
5
7.69
5
7.69
4
6.15
-
585
3.11.
n
%
L
38
58,46
27
41,53
45
69,23
7
10,77
13
20,0
21
32,31
15
23,08
8
12,31
3.12,
n
%
n
%
n
%
n
%
n
%
n
%
n
%
Lúc
vào
39
60.0
55
84.62
10
15.38
0
0
28
43.08
24
36.92
19
29.23
Lúc ra
27
41.53
45
69.23
7
10.77
13
20.0
21
32.31
15
23.08
8
12.31
p
<0,05
>0,05
>0,05
<0,001
>0,05
>0,05
<0,05
n
9
18
20
17
1
%
13,85
27,69
30,77
26,2
1,54
-
586
.
Lit hu hm 32,31%, nhng BN này pht thi gian
còn li vì ý thc không tnh li do sc khi BN ra vin. Tiu qua
sonde ching ht sonde nhiu ngày, ý thc không tnh, loét cùng ct,
m trùng tit niu là rt cao.
Trong nghiê
TBMMNTP là 53,6%.
587
-
-
có 72,30% các
-180 /80-
-
cao 200-220/100-
V.
588
-
-
-
-
-
-
-
-
-
2.
3.
1.
-46.
2.
-71.
3.
-14.
4.
-21.
5.
tr 35-40.
6.
-39.
7.
-192
8. , Viêtlove Sep 2
9. David O.Wiebers, Valery L. Feigin, Robert D. Brow (2000), Handbook of stroke - Sách