脑静脉窦血栓形成的介入治疗  

Endovascular treatment of intracranial venous sinus thrombosis

作　　者：徐树彬[1] 梁志会[1] 崔进国[1] 田惠琴[1] 李亮[1] 陈峰[1] 

机构地区：[1]石家庄白求恩国际和平医院血管外科,050082

出　　处：《介入放射学杂志》2009年第8期572-575,共4页Journal of Interventional Radiology

摘　　要：目的研究血管内介入治疗颅内静脉窦血栓形成的疗效和安全性。方法对10例临床抗凝治疗无效的颅内静脉窦血栓形成患者行血管内介入治疗,全部患者均接受经静脉插管接触性溶栓联合机械性碎栓治疗,其中4例在接受经静脉途径溶栓后又接受了经动脉溶栓。术后继续抗凝治疗6个月,随访12～29个月,平均21个月。结果8例患者的临床症状和体征得到缓解或部分缓解,其中6例头痛消失,2例存在轻度头痛。1例症状无明显改善,1例病程较长的患者残留语言功能障碍。所有患者腰椎穿刺脑脊液压力均恢复正常,未再发生血栓形成和新的神经功能症状。所有患者术中和术后均未发生与操作相关的颅内或全身出血并发症。结论血管内介入治疗颅内静脉窦血栓是安全、有效的治疗手段。Objective To evaluate the clinical effieaey and safety of endovascular treatment for intracranial venous sinus thrombosis. Methods Ten patients with intracranial venous sinus thrombosis, confirmed by CT, MRI, MRV and /or DSA and encountered during the period of Aug. 2005 - Aug. 2007, were treated with endovascular management after they failed to respond to anticoagulant therapy. Of ten patients, intravenous thrombolysis and mechanical thrombus maceration were carried out in 6, while intravenous thrombolysis, mechanical thrombus maceration together with intra-arterial thrombolysis were employed in 4. After the treatment, the anticoagulant therapy continued for 6 months. The patients were followed up for 12- 29 months （mean 21 months）. Results After the treatment, the clinical symptoms and signs were completely or partially relieved in eight patients, including disappearance of headache （n = 6） and relive of headache （n = 2）. No obvious improvement was found in one patient and linguistic function disturbance was seen in the remaining one. Lumbar puncture showed that the eerebrospinal fluid pressure returned to normal in all patients. Neither recurrenee of thrombosis nor new symptom of neuralgic dysfunction was observed. No procedure-related intracranial or systemic hemorrhagic complications occurred both during and after the operation. Conclusion Endovascular treatment is an effective and safe procedure for the potentially catastrophic intracranial venous thrombosis.

关 键 词：静脉窦 血栓形成 血管 介入治疗 

分 类 号：R743.3[医药卫生—神经病学与精神病学]