Klinički ishod praćen primenom skale NIHSS kod bolesnika posle mehaničke trombektomije u odnosu na vreme i cerebrovaskularne faktore rizika
Sažetak
Uvod/Cilj. Mehanička trombektomija (MT) je endovaskularno lečenje koje uključuje uklanjanje trombotičnih masa iz velikih krvnih sudova glave i/ili vrata u prvim satima akutnog ishemijskog moždanog udara (AIMU). Cilj rada bio je da se utvrdi uloga prediktora (vreme i vaskularni faktori rizika) kliničkog ishoda obolelih od AIMU praćenih primenom skale National Institute of Health Stroke Scale (NIHSS). Metode. Ispitivanjem su obuhvaćena 134 bolesnika sa dijagnozom okluzije krvnog suda glave i/ili vrata sa kliničkom slikom AIMU, koji su zadovoljavali kriterijume za MT, a kod kojih su pri prijemu u bolnicu postojali faktori rizika od vaskularnih bolesti. U odnosu na period od nastanka kliničke slike AIMU do vremena početka MT, bolesnici su bili podeljeni u dve grupe. Prvu, ispitivanu grupu, činilo je 85 (63.4%) bolesnika kojima je rekanalizacija započeta u prva četiri sata od pojave simptoma, a drugu, kontrolnu grupu, 49 (36.6%) bolesnika kojima je rekanalizacija započeta posle četvrtog sata. Rezultati su praćeni na osnovu skora primenom skale NIHSS prilikom otpusta bolesnika, 30-og i 90-og dana, u odnosu na NIHSS rezultat pri prijemu bolesnika. Rezultati. Nije bilo statistički značajne razlike između grupa, osim za varijable endovaskularni tretman (EVT) i raniji vaskularni događaj [kardiovaskularna bolest (KVB)] (p < 0,05). Utvrđena je statistički značajna povezanost između poboljšanja i vremena kada je EVT urađen u odnosu na pojavu tegoba (χ2(1) = 4,756; p <0,05). Nađena je statistički značajna povezanost i između poboljšanja i prisutva KVB (χ2(1) = 4,756; p < 0,05). Zaključak. Rezultati naše studije ukazuju na MT kao obećavajuću samostalnu terapijsku proceduru u lečenju AIMU. Klinički ishod posle MT praćen NIHSS skalom, u odnosu na vreme i cerebrovaskularne faktore rizika, pokazuje da bolesnici kod kojih je EVT urađen u prva četiri sata češće imaju poboljšanje od bolesnika kod kojih je EVT urađen posle četiri sata od pojave tegoba. Takođe, bolesnici bez KVB češće imaju poboljšanje od bolesnika sa KVB.
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