重症脑静脉窦血栓形成的超选择窦内置管和机械取栓、碎栓及溶栓治疗  

Super-selective catheterization of cerebral venous sinus together with mechanical thrombectomy and thrombolysis for severe cerebral venous sinus thrombosis

作　　者：盛柳青[1] 马廉亭[1] 杨铭[1] 李俊[1] 陈刚[1] 潘力[1] 李欢欢[1] 伍杰[1] 甘志强[1] 王强[1] 

机构地区：[1]广州军区武汉总医院神经外科解放军神经外科研究所,武汉430070

出　　处：《介入放射学杂志》2013年第12期969-971,共3页Journal of Interventional Radiology

摘　　要：目的 探讨重症脑静脉窦血栓形成的超选择窦内置管和机械取栓、碎栓及溶栓治疗的方法及疗效分析.方法 2010年7月—2012年7月收治10例重症脑静脉窦血栓形成患者,其中静脉窦内置管机械取栓、碎栓及溶栓9例,保守治疗1例.经股静脉插管,将微导管插入上矢状窦前1/3机械取栓、碎栓后留置微导管溶栓,24 h泵入抗凝、抗血小板及溶栓药物,维持3～7d.结果 9例患者痊愈出院,1例患者因脑出血增加自动出院.结论 超选择窦内置管和机械取栓、碎栓及溶栓治疗可尽快开通静脉窦,恢复颅内静脉回流,降低颅内压,降低静脉高压性脑出血发生率,尽快改善临床症状取得满意的效果.Objective To investigate the therapeutic effect of super- selective catheterization of cerebral venous sinus together with mechanical thrombectomy and thrombolysis for the treatment of severe cerebral venous sinus thrombosis, and to discuss its technical skill. Methods During the period from July 2010 to July 2012, a total of 10 patients with severe cerebral venous sinus thrombosis were admitted to the hospital. Of the 10 patients, super-selective catheterization of cerebral venous sinus together with mechanical thrombectomy and thrombolysis was carried out in 9, and conservative management was employed in one. The catheter was inserted via femoral vein, and the micro- catheter was advanced into the anterior one- third segment of the superior sagittal sinus, which was followed by mechanical thrombeetomy and thrombolysis. The micro-catheter was kept in the sinus, through which the anticoagulation, antiplatelet and thrombolytic drugs were continuously pumped in for 3 - 7 days. Results Nine patients were completely cured at the time of discharge. The remaining one patient developed intracranial bleeding and left hospital of his own accord. Conclusion For patients with severe cerebral venous sinus thrombosis, super-selective catheterization of cerebral venous sinus together with mechanical thrombectomy and thrombolysis can open venous sinus and restore intracranial venous flow as early as possible, thus reducing the intracranial pressure and the incidence of intracranial bleeding caused by high venous pressure, and quickly improving the clinical condition as well.

关 键 词：静脉窦血栓形成 机械取栓 溶栓 碎栓 

分 类 号：R743.3[医药卫生—神经病学与精神病学]