脑静脉窦血栓形成伴颅内出血的治疗分析  

The treatment analysis of cerebral venous sinus thrombosis with intracranial hemorrhage

作　　者：张帅美 刘煜敏[1] 黄婧 罗征进 Zhang Shuaimei;Liu Yumin;Huang Jing(Department of Neurology,Zhongnan Hospital of Wuhan University)

机构地区：[1]武汉大学中南医院神经内科

出　　处：《卒中与神经疾病》2019年第5期553-556,共4页Stroke and Nervous Diseases

基　　金：国家自然科学基金面上项目(批准号为81371273)

摘　　要：目的对比单纯抗凝和机械取栓联合局部溶栓治疗颅内静脉窦血栓形成(CVST)伴颅内出血患者的效果。方法回顾性分析2014年6月-2018年6月武汉大学中南医院神经内科收治的28例CVST伴颅内出血患者的病例资料,根据其治疗方式分为单纯抗凝组(12例)和机械取栓组(机械取栓+局部溶栓+抗凝组16例),比较2组患者临床疗效、再通情况及预后。结果机械取栓组的临床疗效、血管再通情况及预后均优于单纯抗凝组(P均<0.05),单纯抗凝组治疗后均未发现新发出血灶,机械取栓组仅有1例术后出现阴道出血。结论对于合并有颅内出血的CVST患者,机械取栓联合局部溶栓治疗能有效促进静脉血流的恢复,缓解临床症状和改善预后。Objective To compare the efficacy of simple anticoagulation and mechanical thrombectomy combined with local thrombolysis in the treatment of intracranial venous sinus thrombosis(CVST) with intracranial hemorrhage.Methods The clinical data of 28 patients with CVST complicated with intracranial hemorrhage from June 2014 to June 2018 in the Department of Neurology,Zhongnan Hospital of Wuhan University were retrospectively analyzed.According to their treatment methods,they were divided into two groups:simple anticoagulation group(n=12) and mechanical thrombectomy group(mechanical thrombectomy+local thrombolysis+anticoagulation group,n=16).Then,the clinical efficacy,recanalization and prognosis of the two groups were compared.Results The clinical efficacy,vascular recanalization and prognosis of mechanical thrombectomy group were superior to those of simple anticoagulation group(P<0.05).No new blood foci were found in the simple anticoagulation group,and only one case in mechanical thrombectomy group had vaginal bleeding after operation.Conclusion For CVST patients with intracranial hemorrhage,mechanical thrombectomy combined with local thrombolysis could effectively promote the recovery of venous blood flow,relieve clinical symptoms and improve prognosis.

关 键 词：静脉窦血栓形成 颅内出血 机械取栓治疗 

分 类 号：R743[医药卫生—神经病学与精神病学]