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[马达加斯加贝费拉塔纳纳神经病学部门脑静脉血栓形成患者的院内及三个月结局:一项回顾性队列研究]

[Intra-hospital and three-month outcomes of patients with cerebral venous thrombosis in the department of neurology in Befelatanana, Madagascar: a retrospective cohort study].

作者信息

Rajaonarison Lala Andriamasinavalona, Rasaholiarison Nomena Finiavana, Randrianantoandro Naliniaina Robert, Rabeony Manitra Niaina, Razafimahefa Julien, Zodaly Noël, Tehindrazanarivelo Alain Djacoba

机构信息

Faculté de Médecine, Université d'Antsiranana, Antsiranana, Madagascar.

Faculté de Médecine, Université de Fianarantsoa, Fianarantsoa, Madagascar.

出版信息

Pan Afr Med J. 2022 Jun 3;42:93. doi: 10.11604/pamj.2022.42.93.29166. eCollection 2022.

Abstract

The prognosis of cerebral venous thrombosis (CVT) is much better than that of cerebral artery (CAI) infarct. The purpose of this study is to describe intra-hospital and three-month outcomes of patients with CVT in the Department of Neurology of Befelatanana as well as the role of anticoagulants in the management of patients with CVT, without and with haemorrhagic suffusion. We conducted a retrospective cohort study of patients with CVT from January 01, 2014 to December 31, 2019 (72 months). Patients´ clinical characteristics and their intra-hospital and three-month outcomes data were collected. Data were analyzed using the R software, by comparing data of patients with CVT, with and without haemorrhagic suffusion and with a significant p ≤ 0.05. We recorded 21/4227 (0.49%) cases of CVT, of whom 11 (52.38%) had CVT with haemorrhagic suffusion. The average age of patients was 38.05 years. The age group 18-34 years (47.62%) was most represented. Women were the predominant gender (76.19%; n=16). On admission, NIHSS score < 10 was found in 85.71% of patients (n=18) and mRS score < 3 was found in 61.90% of patients (n=13). All patients were receiving anticoagulants. Upon discharge from hospital, NIHSS score < 10 was stable (90.47% (n=19)) with an increase in patient with mRS score < 3 (85.71% (n=18)), of whom 3 were in the haemorrhagic suffusion group. The average hospital stay was 16.04 days. One patient in the group without haemorrhagic suffusion died during hospitalisation. At 3 months after discharge, only 9 patients were reachable. Their neurological status improved (NIHSS score < 10 in 100% (n=9) of patients, mRS score= 0 in 88.89% (n=8) of patients). No statistically significant differences were found between the two groups in terms of disability (p=0.757), with a relative risk (RR) of 0.91 CI [0.04; 6.55] and of death (p=0.282) (0 deaths in a group) between the two groups receiving and not receiving anticoagulants. Mortality and disability in patients receiving anticoagulants during the evolution of CVT are very low. The availability of a low-cost brain CT angiography could allow better management of CVT in our Neurology Department.

摘要

脑静脉血栓形成(CVT)的预后远优于脑动脉梗死(CAI)。本研究旨在描述贝费拉塔纳纳神经病学系CVT患者的院内及三个月结局,以及抗凝剂在CVT患者(有无出血性渗出)管理中的作用。我们对2014年1月1日至2019年12月31日(72个月)期间的CVT患者进行了一项回顾性队列研究。收集了患者的临床特征及其院内和三个月结局数据。使用R软件对数据进行分析,比较有和无出血性渗出的CVT患者的数据,p≤0.05具有统计学意义。我们记录了21/4227例(0.49%)CVT病例,其中11例(52.38%)患有伴有出血性渗出的CVT。患者的平均年龄为38.05岁。18 - 34岁年龄组的患者占比最高(47.62%)。女性为主要性别(76.19%;n = 16)。入院时,85.71%的患者(n = 18)美国国立卫生研究院卒中量表(NIHSS)评分<10,61.90%的患者(n = 13)改良Rankin量表(mRS)评分<3。所有患者均接受抗凝治疗。出院时,NIHSS评分<10保持稳定(90.47%(n = 19)),mRS评分<3的患者有所增加(85.71%(n = 18)),其中3例在出血性渗出组。平均住院时间为16.04天。无出血性渗出组中有1例患者在住院期间死亡。出院后3个月,仅联系到9例患者。他们的神经功能状态有所改善(100%(n = 9)的患者NIHSS评分<10,88.89%(n = 8)的患者mRS评分 = 0)。两组在残疾方面(p = 0.757)无统计学显著差异,接受和未接受抗凝剂的两组之间相对风险(RR)为0.91,置信区间为[0.04;6.55],在死亡方面(p = 0.282)(一组无死亡病例)也无统计学显著差异。在CVT病程中接受抗凝治疗的患者死亡率和残疾率非常低。低成本的脑部CT血管造影检查的可获得性能够使我们神经病学系更好地管理CVT。

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Cerebral venous thrombosis.脑静脉血栓形成
Circulation. 2012 Apr 3;125(13):1704-9. doi: 10.1161/CIRCULATIONAHA.111.067835.
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Cerebral venous thrombosis: a diagnostic and treatment update.脑静脉血栓形成:诊断与治疗更新。
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