改良溶栓方案治疗脑静脉窦血栓形成疗效观察

A new thrombolysis scheme for cerebral sinus thrombosis-unremitting injection with microdosis in 48 hours in sinus venosus

目的:探讨经血管内途径治疗脑静脉窦血栓形成的48小时微量溶栓方法的疗效和安全性。方法:对22例患者进行血管内治疗。其中9例采用经典方法治疗,13例患者(9例随机分配患者及4例经典方法禁忌的患者)采用改良方法(静脉窦内留置微导管持续48h微量溶栓术)治疗。术后积极治疗原发病,抗凝治疗6个月。术后随访6～12个月,平均10±2.1月。结果:经典方法组:9例脑静脉窦血栓形成的患者,静脉窦均获得再通,其中1例植入支架1枚,2例并发脑出血(1例在右侧顶叶,1例在左侧小脑),并发脑出血的1例患者遗留面瘫,NIHSS评分1分,其余8例0分,预后良好。改良方法组:13例脑静脉窦血栓形成患者(其中含相对禁忌证病例1例,禁忌证病例3例),脑静脉窦均获得再通,无一例并发或加重脑出血,病程超过3个月的1例患者术后1个月残留语言功能障碍NIHSS评分1分,其余12例0分,预后良好。结论:经典方法可以有效治疗脑静脉窦狭窄及血栓形成,但并发脑出血的风险较大,改良方法"脑静脉窦48h微量溶栓术"有效规避了大量应用溶栓药物的问题,在达到同样疗效情况下更为安全,拓展了血管内途径治疗范围。

Objective:To discuss the curative effect and the risk of unremitting microdosis injection in 48hours in sinus venosus for cerebral sinus thrombosis.Methods:22 cases with multipath endovascular treatment,9 cases with classics scheme and 13 cases with improved scheme(unremitting injection with microdosis in 48hours in sinus venosus).Results:In classics scheme group:All of the 9 cases were underwent transvenors thrombolysis.Meanwhile,one of the cases was treated with stenting,2 cases complicating cerebral hemo...