科维德-19 期间急性缺血性中风(AIS)后颈内动脉(ICA)内膜剥脱术后患者的生活质量

IF 1 Q4 PSYCHOLOGY Acta Neuropsychologica Pub Date : 2023-07-03 DOI:10.5604/01.3001.0053.8593
Ksenia Cielebąk, Mikołaj Kobos, Jolanta Góral-Półrola
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引用次数: 0

摘要

该研究旨在评估一名在 COVID-19 期间接受颈内动脉(ICA)内膜切除术(CEA)的急性缺血性中风(AIS)患者的生活质量。该患者右撇子,51 岁,视觉艺术家,单身,健康状况良好,迄今无慢性疾病,感染了 SARS-CoV-2,并感染了 COVID-19。经 RT PCR 抗原检测,证实感染了 SARS-CoV-2 病毒。在急性缺血性中风(AIS)发病前,患者曾住院治疗,并需要在重症监护室(ICU)进行机械通气。除了未经治疗的高血压外,她的病史并无异常。她的血压为 180/100 mm Hg,脉搏为每分钟 76 次,很规律。来自左侧大脑中动脉(MCA)的 AIS 主要导致左侧大脑半球受损,并继发右侧大脑半球受损,造成身体虚弱和轻度失语。磁共振成像(MRI)证实了中风,并检测到因 AIS 而受损的脑组织。它在 T2 和 FLAIR 序列中发现了左侧大脑半球 21 毫米大小的高密度灶。为了寻找 AIS 的病因,进行了 CT 血管造影。结果显示,大面积(90%)ICA闭塞。患者在血管外科诊所急诊室接受了血管内介入治疗。在气管内全身麻醉下,按照克拉科夫约翰-保罗二世医院血管外科和血管内手术部制定的方案和技术进行了血管重建手术(CEA)。CEA 手术改善了她的总体健康状况:她恢复了说出物体名称的能力,在感知方面,她的 HRQOL 也得到了改善。所取得的改善具有显著的统计学意义。CEA 术后,患者通过 SF-36 领域衡量的 HRQoL 感知有所改善:自我报告的总体健康状况有了明显改善。HRQoL 结果测量在未来比较 AIS 后不同治疗方法的临床试验中可能很有价值。
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QUALITY OF LIFE OF A PATIENT AFTER ENDARTERECTOMY OF THE INTERNAL CAROTID ARTERY (ICA) FOLLOWINGAN ACUTE ISCHEMIC STROKE (AIS) DURING COVID-19
The aim of the study was to evaluate the quality of life of a patient af- terendarterectomy (CEA) of the Internal Carotid Artery (ICA) following an Acute ischemic stroke (AIS) during COVID-19.A right-handed, 51-year-old patient, a visual artist, single, in good health and no chronic illnesses to date, became infected with SARS-CoV-2 and contracted COVID-19. The presence of SARS-CoV-2 virus was confirmed by a RT PCR antigen test. The patient was hospitalized, and required mechanical ventilation at an Intensive Care Unit (ICU) before an acute ischemic stroke (AIS) onset. Except for untreated hypertension, her medical history was unremarkable. Her blood pressure was 180/100 mm Hg; her pulse was 76 beats per minute and was regular. AIS from the left middle cerebral artery (MCA) has resulted primarily in damage to the left hemisphere, and secondary effects on the right side resulting in body weakness and mild anomic aphasia. Magnetic resonance imaging (MRI) confirmed stroke and detected brain tissue damaged by an AIS. It revealed hyperintense foci in the T2 and FLAIR sequences, 21 mm in size in the left hemisphere of the brain. In search of the cause of AIS, CT angiography was performed. It revealed a large (90%) ICA occlusion. The patient was admitted to the emergency room at the Vascular Surgery Clinic with an Endovascular Subunit. The revascularization procedure (CEA) was performed under general endotracheal anesthesia with the use of the protocol and techniques (elaborated at the Department of Vascular Surgery and Endovascular Procedures, The John Paul II Hospital in Krakow). The CEA procedure improved her general health: she regained the ability to name objects and her HRQOL also improved in her perception. The improvement achieved was statistically significant. She returned to painting and functions well in society.The patient’s perception of HRQoL measured by the SF-36 domains was better after the CEA: a significant improvement in self-reported overall health has occured. The HRQoL outcome measures may be valuable in future clinical trials of comparing different methods of treatment offered after AIS.
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