颅内静脉窦血栓形成并颅内血肿患者预后相关因素分析  

Factors influencing prognosis of cerebral venous thrombosis patients with intracranial hematoma

作　　者：李维[1] 何旭英[1] 李西锋[1] 张炘[1] 段传志[1] 

机构地区：[1]国家临床重点专科,教育部工程技术研究中心,广东省脑功能修复与再生重点实验室.南方医科大学珠江医院神经外科,广州510282

出　　处：《中华神经医学杂志》2017年第12期1265-1269,共5页Chinese Journal of Neuromedicine

摘　　要：目的探讨颅内静脉窦血栓形成（CVST）合并颅内学肿（ICH）患者预后的影响因素。方法南方医科大学珠江医院神经外科自2007年4月至2017年4月收治颅内CVST合并ICH患者28例，其中行联合治疗（介入治疗联合开颅手术、介入治疗联合抗凝治疗）17例，行单一治疗（抗凝治疗或开颅手术）11例。回顾性分析患者的临床资料和疗效，统计分析影响患者预后的相关危险因素。结果本组预后良好患者15例，预后不良患者13例。与预后良好组比较，预后不良组患者的意识障碍、血肿量〉30mL、中线偏移〉10min及接受单一治疗患者比例较高，差异有统计学意义（P〈O．05）。结论意识障碍、血肿量〉30mL、中线偏移〉10mm及接受单一治疗是CVST合并ICH患者预后不良的危险因素。Objective To explore the factors that may influence the prognosis of patients with cerebral venous thrombosis （CVST） combined with intracranial hematoma （ICH）. Methods Twenty-eight consecutive patients with CVST combined with ICH, admitted to our hospital from April 2007 to April 2017, were chosen in our study; 17 accepted combined treatment （endovascular treatment combined with anticoagulation therapy or endovascular treatment combined with surgery） and 11 of them accepted single therapy （anticoagulation therapy or surgery）. Their clinical data were retrospectively reviewed. Follow-up outcomes were evaluated using modified Rankin Scale （mRs） and risk factors of recurrence were analyzed. Results Fifteen patients had good outcomes and 13 had poor outcomes. As compared with patients with good outcomes, patients with poor outcomes had significantly higher incidence rate of disturbance of consciousness, statistically higher percentages of hematoma volume 〉30 mL and midline shitt〉10 mm and ratio of single treatment （P〈0.05）. Conclusions The prognoses of CVST patients with ICH may be influenced by disturbance of consciousness, hematoma volume〉30 mL, midline shift〉 10 mm and treatment protocol.

关 键 词：静脉窦血栓 血管内治疗 抗凝 

分 类 号：R743.3[医药卫生—神经病学与精神病学]