儿童脑静脉窦血栓形成6例病例分析并文献复习  

Cerebral Venous Sinus Thrombosis In Children：Six Case Report and Literature Review

作　　者：纳玉辉[1] 戴梅[1] 熊晶晶[1] 王珺[1] 莫亚雄[1] 

机构地区：[1]昆明医科大学第一附属医院儿科,云南昆明650032

出　　处：《医药前沿》2015年第10期68-71,共4页Journal of Frontiers of Medicine

摘　　要：目的：探讨儿童脑静脉窦血栓形成（Cerebral venous sinus thrombosis，CVST）的诱因、临床特征、诊断、治疗及近期预后。方法：回顾性分析2011年1月至2014年6月收住昆明医科大学第一附属医院儿科的6例CVST患儿临床资料。结果：4/6的CVST患儿为亚急性起病。4/6的患儿有上呼吸道/或消化道感染等诱因，2/6合并副鼻窦炎。6例患儿首发症状均为头痛，66.7%有视乳头水肿和脑脊液压力增高。头颅MRI联合MRV显示病变多见于上矢状窦（4/6）、横窦（4/6）及乙状窦（3/6）。经抗凝、抗血小板、降低颅内压、抗感染及对症支持治疗，症状、体征好转，未遗留神经功能缺损。治疗后随访3个月，5/6的患儿影像学复查脑静脉显影好转。结论：儿童CVST以头痛、颅内压增高为主要表现,头颅MRI联合MRV检查是早期诊断儿童CVST最重要的手段。CVST首选的治疗方法是抗凝治疗，阿司匹林抗血小板治疗可用于儿童CVST。早期诊断和治疗有助于改善预后，治疗后应加强神经科和眼科随访。Objective To investigate the cause, clinical features, diagnosis, treatment and the short-term prognosis of cerebral venous sinus thrombosis （CVST） in children.Methods A retrospective survey was performed in 6 cases that were diagnosed with CVST in the pediatric ward of The First Affiliated Hospital of Kunming Medical University from Jan. 2011 to Jun. 2014.Results 4/6 of the patients were subacute onset. 4/6 patients had precipitating factors of upper respiratory tract or gastrointestinal infections , 2/6 patients complicated with sinusitis. 6 cases of children with symptom were headache, 4/6 had papillary edema and increased CSF pressure. MRI combined with MRV showed lesions in the superior sagittal sinus （4/6） , the transverse sinus（4/6） and sigmoid sinus （3/6）. Anticoagulation, antiplatelet, reducing intracranial pressure, anti infection and supportive treatment, 6 cases cured, no neural function defect . Patients were followed up for 3 months, 5/6 children with improved imaging of cerebral venous.Conclusion CVST in children with headache, increased intracranial pressure as the main manifestations, MRI combined with MRV is the most important tests of early diagnosis in children with CVST. Anticoagulant is recommended as first-line treatment of CVST , Aspirin can be used for children with CVST. Early diagnosis and treatment is helpful to improve the prognosis .The neurology and ophthalmology after the treatment should be followed up.

关 键 词：脑静脉窦血栓形成 儿童 诊断和治疗 

分 类 号：R720.5[医药卫生—儿科]