妊娠相关脑静脉及静脉窦血栓形成的临床分析  

Clinical Analysis of Pregnancy Associated Cerebral Venous Thrombosis

作　　者：高辉[1] 金丽萍[1] 贾晓芳[1] 

机构地区：[1]首都医科大学附属北京天坛医院妇产科,100050

出　　处：《医学研究杂志》2011年第7期101-104,共4页Journal of Medical Research

摘　　要：目的探讨妊娠相关脑静脉及静脉窦血栓形成(CVT)的临床特点及治疗方法。方法回顾性分析22例妊娠相关CVT病例的临床特点及影像学特征,结合文献复习其诊断治疗方法。结果 CVT可发生于整个妊娠及产后过程,产褥期发生率更高。妊娠期发病者常伴有脱水、感染等,产褥期患者常无诱因。首发症状以头痛最多见(81.82%),其次为癫痫发作、言语不利、一侧肢体无力感。55.56%的患者CT可见特征性改变,磁共振成像检查确诊率达94.4%。最易受累的部位为上矢状窦和右侧横窦,77.27%的病例累及多个静脉窦和(或)静脉。经抗凝、降颅压等对症治疗后,63.63%的病例完全恢复或偶有头痛头晕。抗凝治疗不增加产后出血量。结论妊娠相关CVT是青年女性脑卒中的重要原因之一。早期诊断、尽早抗凝治疗,多数孕产妇可获得较好结局。Objective To investigate the clinical characteristics and treatment for pregnancy associated cerebral venous thrombosis. Methods We retrospectively collected 22 cases of pregnancy associated cerebral venous thrombosis and summarized the clinical features and imaging demonstrations in combination of reviewing related literature. Results CVT may take place during the pregnancy and post- partum, mostly during postpartum. During pregnancy, CVT usually was concomitant with induced factors like dehydration, infection, but its presence during postpartum usually was not associated with such factors. Among the initial symptoms, headache （81.82%） was most frequent, and the next in turn were epilepsy, barylalia, one lateral paralysis. In 55.56% cases, typical CT images can be observed, and MRI can achieve an accuracy rate of 94.4% in diagnosis. The most involved sites included superior sagittal sinus and right transverse si- nus, and in 77.27% cases multiple sinuses or veins were involved. After coagulation and lowering intracranial pressure, 63.63% of the patients recovered completely or with occasional dizziness. Coagulation did not increase postpartum bleeding. Conclusion Pregnancy as- sociated CVT is one of the most important causes for cerebral stroke in young women. Early diagnosis and instant treatment using coagulation will result in good outcomes in most patients.

关 键 词：妊娠 产褥期 妊娠相关脑卒中 静脉窦血栓形成 抗凝 

分 类 号：R743.320.4[医药卫生—神经病学与精神病学]