小儿颅内静脉窦血栓31例临床分析  

Cerebral venous sinus thrombosis in children: an analyses of 31 patients

作　　者：王建祯[1] 何心[2] 张开[3] 唐红[1] 牛建星[1] 李钟铭[1] 杜长生[1] 郑莉莉[1] 

机构地区：[1]武警总医院神经外科,北京100039 [2]郑州市儿童医院神经外科,郑州450053 [3]武警总医院麻醉科,北京100039

出　　处：《河南外科学杂志》2013年第6期4-6,共3页Henan Journal of Surgery

摘　　要：目的分析小儿颅内静脉窦血栓(CVST)的临床及影像学特点、发病原因、治疗方法和预后因素。方法回顾性分析31例小儿CVST患者的病因、临床和影像学表现、治疗方法和预后情况。结果小儿CVST的病因包括创伤、感染、血液系统疾病,肾病综合征、恶性肿瘤等。意识障碍、颅内压增高、癫痫发作和局灶性神经功能障碍是主要临床表现。影像学检查能够显示不同程度的脑静脉窦闭塞和脑损伤。降低颅内压、抗凝及血管内治疗是主要的治疗方法。31例患儿中治愈18例(58%),好转8例(25.8%),死亡5例(16.1%)。结论小儿CVST病因复杂,临床表现多样,影像学检查是临床诊断的主要依据,早期诊断和治疗可提高疗效和改善预后。Objective To analyze the characteristics of clinical, and radiological of cerebral venous sinus thrombosis （CVST） in chil- dren, and investigate the therapeutic strategies and predictors of outcome. Methods The etiology, diagnosis and treatment were analyzed retrospectively in 31 children. Results The etiology of CVST in childhood includes brain injury, inflammation, hematopoietic diseases, nephrotic syndrome, and malignancy. Decreased level of consciousness, symptoms of increased intracranial pressure and Seizures were major clinical manifestations. Neuroimaging study showed occlusions of cerebral veins and sinus and parenchymal abnormalities. Patients were administrated with decreasing intracranial pressure, symptomatic treatment, anticoagulation and local thrombolysis therapy. 18 patients were recovered （58%）, 8 cases improvement（25.8% ） and 5 died（ 16.1% ）. Conclusion Since the causes of CVST are complicated, and clinical manifestations were variable, neuroimaging examination is proved to be the effective diagnosis tool. Early diagnosis and suitable treatment may improve the prognosis.

关 键 词：脑静脉窦血栓 小儿 抗凝 血管内治疗 

分 类 号：R651[医药卫生—外科学]