PHÂN TÍCH MỘT SỐ YẾU TỐ LIÊN QUAN ĐẾN CHỈ ĐỊNH ĐẶT NỘI KHÍ QUẢN Ở BỆNH NHÂN NHỒI MÁU NÃO DIỆN RỘNG BÁN CẦU

Abstract

Background: Analysis of some factors among clinical features, images and indication for intubation of large cerebral infarction patients. Objectives: Study of 69 patients with acute large hemispheric infarction, of which 38 patients without the intubation and 31 patients with the intubation, were treated in Neurological Center of Bach Mai Hospital from August 2020 to July 2021. Method: Cross-sectional descriptive study. Result: The average age of patients was 68,41 ± 11,65, the percentage of male was 60.9%. Frequent clinical symptoms onset included: paralysis (100%), language disorder (97.1%), headache (30.4%), nausea/vomiting (30.4%), consciousness disorder (60.9%), head-eye deviation (46.4%), urinary and fecal incontinence (47.8%). The mean of NIHSS score, Glasgow score and ASPECT score at hospital admission were 19.0±3.84, 12.9±1.36 and 4,59±1,0,  resprectively. The dregree of midline shift was 4,48 ± 3,97mm, hemorrhagic transformation patients accounted for 24.6%. Factors related to indication for intubation with statistical significance included: consciousness disorder at onset (OR: 20.83, 95% CI: 1.18 - 36.78), head-eye deviation (OR: 4.41, 95% CI: 1.34 – 14.49), NIHSS score at hospital admission ≥ 20 points (OR: 39.48, 95% CI: 1.63 – 95.53), displacement midline ≥ 5 mm (OR: 13.65, 95% CI: 2.10 – 88.90). Conclusion: Large hemispherical infarction is a severe form of stroke with high morbidity and mortality. Factors related to indication for intubation at hemispherical infarction patients included: consciousness disorder at onset, head-eye deviation, NIHSS score at hospital admission ≥ 20 points, midline shift classification ≥ 5mm.