血管内治疗儿童重型脑静脉窦血栓的安全性及疗效分析  

Safety and efficacy of endovascular treatment in pediatric severe cerebral venous sinus thrombosis

作　　者：付晓杰 权涛[1] 袁永杰 徐浩文[1] 管生[1] Fu Xiaojie;Quan Tao;Yuan Yongjie;Xu Haowen;Guan Sheng(Department of Neurointervention,First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院神经介入科,郑州450052

出　　处：《中华实用儿科临床杂志》2024年第7期505-509,共5页Chinese Journal of Applied Clinical Pediatrics

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20190076)。

摘　　要：目的研究血管内治疗儿童重型脑静脉窦血栓(CVST)的安全性及疗效。方法病例系列研究。回顾性分析2016年1月至2023年12月于郑州大学第一附属医院神经介入科就诊并接受血管内治疗的儿童重型CVST患者临床数据, 从技术可行性、围术期并发症、神经功能及影像学预后等方面分析血管内治疗儿童重型CVST的安全性及疗效。结果 15例患儿纳入本研究, 其中男6例(40.0%), 女9例(60.0%), 年龄(14.60±2.26)岁。术前改良的Rankin量表(mRS)评分为(3.47±1.06)分, 发病至手术时间为17(12~26) d。13例(86.7%)接受机械取栓术(包括导管抽吸和/或支架取栓并必要时置管溶栓), 2例(13.3%)接受静脉窦置管溶栓术。手术技术成功率100%。3例(20.0%)出现围术期并发症, 10例(66.7%)出院mRS≤2分。12例(80.0%)有有效临床及影像学随访资料, 随访时间9.5(3.5~19.0)个月, 12例患儿mRS≤2分, 其中8例(66.7%)静脉窦良好复通。结论血管内治疗儿童重型CVST技术可行性高, 具有可以接受的安全性和有效性。Objective To study the safety and efficiency of endovascular treatment in pediatric severe cerebral venous sinus thrombosis(CVST).Methods This was a case series study.Data of pediatric severe CVST patients who received endovascular treatment in the Department of Neurointerventional,the First Affiliated Hospital of Zhengzhou University from January 2016 to December 2023 were retrospectively analyzed.The technical success rate,periprocedural complications,neurologic and radiologic outcomes were collected to study the safety and efficacy of endovascular treatment in pediatric severe CVST.Results A total of 15 patients were included in this study,including 6 males(40.0%)and 9 females(60.0%)with a mean age of(14.60±2.26)years.The modified Rankin Scale score(mRS)before endovascular treatment was(3.47±1.06)points,and the time from onset to endovascular treatment was 17(12-26)days.Thirteen patients(86.7%)received mechanical thrombectomy through catheter aspiration and/or stent-retriever thrombectomy followed or not followed by intrasinus thrombolysis(IST),and 2 patients(13.3%)received IST only.The technical success rate was 100%.Three patients(20.0%)had periprocedural complications.Ten patients(66.7%)had mRS≤2 points at discharge.Twelve patients(80.0%)had valuable neurologic and radiologic follow-ups with a duration of 9.5(3.5-19.0)months,and they all had mRS≤2 points.Among the 12 patients,8(66.7%)had good cerebral venous recanalization.Conclusions Endovascular treatment is technically feasible in pediatric severe CVST patients,with acceptable safety and efficacy.

关 键 词：儿童 脑静脉窦血栓 血管内治疗 机械取栓 置管溶栓 

分 类 号：R726.5[医药卫生—儿科]