应用Solitaire AB支架机械取栓联合溶栓治疗颅内静脉窦血栓形成的疗效观察  

Mechanical thrombectomy with solitaire AB stents in combination with thrombolysis for treatment of intracranial venous sinus thrombosis: a clinical observation

作　　者：陈光忠[1,2] 曾少建[1,2] 詹升全[1,2] 林晓风[1,2] 唐凯[1,2] 周东[1,2] 周德祥[1,2] 秦琨[1,2] 舒航[1,2] 

机构地区：[1]广东省人民医院神经外科,广州510008 [2]广东省医学科学院广东省神经科学研究所,广州510008

出　　处：《中国脑血管病杂志》2013年第10期523-527,共5页Chinese Journal of Cerebrovascular Diseases

基　　金：广东省科技计划项目(2010B031600162)

摘　　要：目的 探讨应用Solitaire AB支架进行颅内静脉窦血栓机械取栓的安全性和有效性.方法 回顾性分析广东省人民医院2010年1月--2012年10月应用Solitaire AB支架对颅内静脉窦血栓机械取栓的16例患者的临床资料,并进行3个月至1年的随访.结果 ① 16例患者中男6例,女10例.单纯上矢状窦血栓4例,上矢状窦＋侧窦血栓4例,上矢状窦及皮质静脉血栓3例,横窦及乙状窦血栓2例,上矢状窦及直窦血栓2例,上矢状窦＋直窦及皮质静脉血栓1例.②应用Solitaire AB支架20枚,同时应用尿激酶30万~70万U进行接触性溶栓3例.16例患者术后症状均明显改善,入院时格拉斯哥昏迷量表评分：3分1例,12分1例,15分14例.出院时格拉斯哥预后量表评分5分15例,4分1例.无一例患者发生支架取栓相关并发症.③随访3个月至1年,其中通过电话随访2例,门诊随访3例,MRV随访8例,DSA随访3例,无一例复发.结论 应用Solitaire AB支架进行颅内静脉窦机械取栓可显著改善患者的临床症状,单中心的经验显示无明显并发症发生.Objective To investigate the safety and effectiveness of mechanical thrombectomy for in- tracranial dural sinus thrombosis with Solitaire AB stents. Methods The clinical data of 16 patients with intracranial dural sinus thrombosis treated with mechanical thrombectomy by using Solitaire AB stents in Guangdong General Hospital from January 2010 to October 2012 were analyzed retrospectively. The patients were followed up for 3 to 12 months after the procedure. Results ①Of the 16 patients, 6 were males and 10 were females. Four had superior sagittal sinus thrombosis, 4 had superior sagittal sinus and lateral sinus thrombosis, 3 bad superior sagittal sinus and cortical vein thrombosis, 2 had transverse sinus and sigmoid sinus thrombosis, 2 had superior sagittal sinus and straight sinus thrombosis, and 1 had superior sagittal si- nus and straight sinus and cortical venous thrombosis. ②Twenty Solitaire AB stents were used. At the same time, 3 patients performed catheter-directed thrombolysis with urokinase 300 000 to 700 000 U. The post- operative symptoms in all the 16 patients were improved significantly. Glasgow coma scale scores at admis- sion： 1 case was 3, 1 was 12, and 14 were 15. Glasgow outcome scale scores at discharge： 15 cases were 5, and 1 was 4. None of the patients occurred embolectomy-related complications. ③The patients were fol- lowed up for 3 to 12 months, 2 were followed up by telephone, 3 were followed up at the outpatient depart-ment, 8 were followed up with MR venography, 3 were followed up with DSA, and none had recurrence. Conclusion Using Solitaire AB stents for intracranial venous sinus mechanical embolectomy may signifi- cantly improve the clinical symptoms of patients. Single-center experience has shown that no obvious com- plications occurred.

关 键 词：窦血栓形成 颅内 SOLITAIRE AB支架 机械取栓 

分 类 号：R743[医药卫生—神经病学与精神病学]