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目的探讨颅内静脉窦血栓形成的诊断及治疗体会。方法回顾性分析我科收治的30例颅内静脉窦血栓形成患者的病因、临床表现、影像学特征、诊疗方案及预后情况。结果颅内静脉窦血栓形成多数为急性或亚急性发病,继发于感染7例,非感染性18例,其中产褥期发病12例;5例病因不明。上矢状窦血栓形成是最常见的。头痛、恶心、呕吐、视力下降、癫痫及局灶性神经系统症状为主要临床表现。治疗方案中单纯肝素抗凝治疗23例,肝素联合静脉窦内溶栓治疗7例。本组22例患者痊愈,4例遗留残疾或后遗症,4例死亡。结论 CVST的临床表现变异很大且缺乏特异性,常见于育龄期妇女。因此关注患者是否存在CVST发生的高危因素,尽早行颅脑CT、MRI、MRV或DSA检查,明确诊断后应积极地抗凝治疗,必要时联合介入溶栓治疗,并纠正病因、对症治疗,大多预后较好。
Objective To investigate the diagnosis and treatment of intracranial venous sinus thrombosis. Methods Retrospective analysis of 30 patients with intracranial venous sinus thrombosis admitted to our department of etiology, clinical manifestations, imaging features, diagnosis and treatment programs and prognosis. Results The majority of intracranial venous sinus thrombosis was acute or subacute. Seven cases were secondary to infection and 18 were non-infectious. Incidence of puerperal was 12 cases. Five cases were unknown. Upper sagittal sinus thrombosis is the most common. Headache, nausea, vomiting, decreased vision, epilepsy and focal neurological symptoms as the main clinical manifestations. Heparin anticoagulant therapy in the treatment of 23 cases of heparin and venous thrombolytic therapy in 7 cases. The group of 22 patients recovered, 4 cases of residual disability or sequelae, 4 patients died. Conclusion The clinical manifestations of CVST vary greatly and lack of specificity, common in women of childbearing age. Therefore concerned about the existence of patients with high risk factors for CVST, as early as possible brain CT, MRI, MRV or DSA examination, a clear diagnosis should be aggressive anticoagulant therapy, if necessary, interventional thrombolytic therapy, and correct the cause, symptomatic treatment, mostly The prognosis is good.