机械血栓去除术治疗颅内静脉窦血栓有效性和安全性的文献分析  

Efficacy and safety of mechanical thrombectomy in cerebral venous sinus thrombosis: a literature review

作　　者：周鸿雁[1] 张德元[2] 孙逊沙 申存周 王海燕[1] 冯黎[1] 陈玲[1] ZHOU Hongyan;CHEANG Tuckyun;SUN Xunsha;SHEN Cunzhou;WANG Haiyan;FENG Li;CHEN Ling(Department of Neurological Intensive Care Unit,the First Affiliated Hospital of Sun Yat-Sen University,Guangzhou,510080,P.R.China;Department of Breast and Thyroid Surgery,the First Affiliated Hospital of Sun Yat-Sen University,Guangzhou,510080,P.R.China)

机构地区：[1]中山大学附属第一医院神经科,广州510080 [2]中山大学附属第一医院甲状腺乳腺外科,广州510080

出　　处：《中国循证医学杂志》2019年第7期836-843,共8页Chinese Journal of Evidence-based Medicine

基　　金：广东省重大神经疾病诊治研究重点实验室项目(编号:2014B030301035);华南神经疾病早期干预及功能修复研究国际合作基地项目(编号:2015B050501003);广州市重大神经系统疾病临床医学研究与转化中心项目(编号:201604020010)

摘　　要：目的系统评价机械血栓去除术治疗颅内静脉窦血栓(CVST)患者的有效性和安全性。方法计算机检索The Cochrane Library、PubMed、EBSCO、Web of Science、CBM、CNKI和VIP数据库,搜集机械血栓去除术治疗CVST的相关临床病例报告,检索时限均为建库截至2018年4月。由2位评价员独立筛选文献、提取资料后,对纳入的研究进行定性分析。结果共纳入33个病例报告,包括552例患者。157例(30%)患者存在肢体局灶症状,145例(28%)患者术前存在颅内梗死或出血,152例(29%)患者有意识障碍。最常见的取栓装置是导丝。483例(88%)患者临床结局较好,35例(6%)患者死亡。333例(65%)患者血管几乎完全再通,148例(29%)患者部分再通,14例(2.5%)患者术后新发出血或原有出血增大。结论当前有限证据提示机械血栓去除术对于多数CVST患者安全有效。受纳入研究数量和质量的限制,上述结论尚需更多研究予以验证。Objectives To review the efficacy and safety of mechanical thrombectomy in patients with cerebral venous sinus thrombosis(CVST). Methods We searched The Cochrane Library, PubMed, EBSCO, Web of Science,CBM, CNKI and VIP databases to collect studies on mechanical thrombectomy in CVST patients from inception to April,2018. Two reviewers independently screened literature, extracted the data and qualitative analysis of the included studies.Results A total of 33 studies including 552 patients were included for data analysis. Specifically, 157(30%) patients had a focal neurological deficit, 145(28%) patients had a pretreatment intracerebral hemorrhage or infarct, and 152(29%)patients were stuporous or comatose. Wire was the most commonly used device. Overall, 483(88%) patients had good outcome, while 35(6%) patients deceased. Moreover, 333(65%) patients had complete recanalization, 148(29%) patients had partial recanalization, and 14(2.5%) patients had worsen or new intracranial hemorrhage. Conclusions The current evidence suggests that mechanical thrombectomy is reasonably safe in the majority of cases. Due to limited quality and quantity of included studies, more high quality studies are required to verify above studies.

关 键 词：静脉窦血栓 机械取栓术 介入治疗 病例报告 

分 类 号：R651.12[医药卫生—外科学]