脑静脉血栓的治疗方法探讨  

Study of treatment methods for cerebral venous thrombosis

作　　者：李生[1] 李宝民[1] 余新光[1] 张远征[1] 王君[1] 曹向宇[1] 李翀[1] 

机构地区：[1]中国人民解放军总医院神经外科,北京100853

出　　处：《中国微侵袭神经外科杂志》2006年第7期293-296,共4页Chinese Journal of Minimally Invasive Neurosurgery

基　　金：国家自然科学基金资助项目(30370496)

摘　　要：目的探讨脑静脉血栓的治疗方法。方法对133例脑静脉血栓单独或联合采用经颈动脉溶栓、静脉窦内留置微导管连续溶栓、静脉窦成形(支架置入或球囊扩张)等方法进行治疗,同时辅以全身抗凝治疗。结果治疗后颅内压均明显下降,除1例ICP降至350mmH2O者失明,1例行静脉窦球囊扩张成形者(拒绝接受静脉窦支架置入)由术前760mmH2O降至450mmH2O外,其余病人ICP基本稳定在200～260mmH2O。颅内出血严重致脑疝死亡2例。溶栓后发生脑出血3例,均经手术治愈。结论同时应用血管内溶栓和全身抗凝是治疗脑静脉血栓较为可靠和安全的方法;血栓部位不同者治疗方案应个性化。Objective To explore the methods for treating cerebral venous thrombosis. Methods One or more of methods were taken for thrombolysis via the carotid, indwelling micro-catheter in the sinus via jugular approach and sinus angioplasty （implantation of stent or dilatation with balloon） in 133 patients with cerebral venous thrombosis. In the meantime, general anticoagulation was given. Results The intracranial pressure （ICP） decreased obviously after the treatment. In 1 case the ICP was 350 mmH2O and the patient became blind. In another patient, who refused the implantation of stent in sinus, the ICP decreased from 760 mmH2O to 450 mmH2O. The ICP was stable between 200 to 260 mmH2O after the treatment in the rest patients. Two patients with severe intracranial hemorrhage died ofccrebral hernia. Three patients had cerebral hemorrhage and were cured by operation. Conclusion Combination of endovascular thrombolysis and general anticoagulation is a safe and reliable method for cerebral venous thrombosis. The treatment should be individualized according to the position of the thrombus.

关 键 词：窦血栓形成 颅内 栓子清除术 血栓溶解疗法 抗凝药 

分 类 号：R743.3[医药卫生—神经病学与精神病学]