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目的提高对重症急性静脉窦血栓的早期诊断和治疗的认识。方法回顾性分析2011年1月至2011年12月期间在我院住院治疗的29例重症急性静脉窦血栓患者的临床资料。所有患者均采用一侧股动脉及对侧股静脉Seldinger穿刺,导管置入一侧静脉窦血栓处后,于颈内动脉及静脉窦血栓处先后各用尿激酶50万U,同时予全身肝素化。结果 29例患者中,25例基本痊愈,4例症状好转。患者无神经功能障碍,经数字减影血管造影见浅表静脉扩张消失,静脉窦显影较前明显好转,并伴有不同程度的侧支循环血管的建立。结论重症急性静脉窦血栓病因复杂,临床表现缺乏特异性,早期的正确诊断和治疗至关重要。采用动静脉系统联合应用尿激酶局部溶栓治疗是快速、安全、有效的方法。
Objective To improve the early diagnosis and treatment of severe acute sinus thrombosis. Methods The clinical data of 29 patients with severe acute sinus thrombosis hospitalized in our hospital from January 2011 to December 2011 were retrospectively analyzed. All patients were treated with Seldinger puncture on one femoral artery and contralateral femoral vein. After the catheter was placed into the venous sinus thrombus, 500,000 U of urokinase was administered to each of the internal carotid artery and venous sinus thrombosis. Meanwhile, systemic heparinization . Results Among the 29 patients, 25 patients recovered basically and 4 patients got better symptoms. Patients without neurological dysfunction, digital subtraction angiography showed superficial venous dilatation disappeared, sinus evoked significantly improved compared with the previous, accompanied by varying degrees of collateral vessels. Conclusion The causes of severe acute sinus thrombosis are complex and the clinical manifestations are not specific. Early diagnosis and treatment are very important. The use of arteriovenous system combined with local thrombolytic therapy of urokinase is a fast, safe and effective method.