脑静脉窦血栓的综合血管内治疗

Combined Endovascular Treatment of Cerebral Venous Sinus Thrombosis

目的评价综合应用颈动脉溶栓、静脉窦置管溶栓及静脉窦支架置入术治疗脑静脉窦血栓的疗效。方法对我科1997年7月～2005年6月收治的99例脑静脉窦血栓患者进行综合血管内治疗,其中5例患者接受静脉窦置管溶栓合并静脉窦支架置入术(方案1),38例患者接受颈动脉溶栓合并静脉窦置管溶栓(方案2),56例患者接受单纯颈动脉溶栓(方案3),观察3组患者的临床疗效。结果经治疗,99例患者中有94例颅内压降至300 mm H_2O, 75例患者静脉窦实现再通,93例患者循环时间降至11 s以下。结论综合应用颈动脉溶栓、静脉窦置管溶栓及静脉窦支架置入术等方法治疗脑静脉窦血栓是一种安全、有效的手段。

Objective To estimate the effects of endovascular thrombolytic treatments which consist of injection of uro- kinase via common carotid artery,direct thrombolysis and stent angioplasty.Methods All the data of 99 patients with cerebral venous thrombosis treated in our department were analyzed retrospectively.Of them,5 patients were treated with direct thrombol- ysis and stent angioplasty (protocol 1);38 were treated with injection of urokinase via common carotid artery and direct throm- bolysis (protocol 2);56 were treated with injection of urokinase via common carotid artery (protocol 3).Results Alter treat- ment intracranial pressure of 94 cases reduced to 300 mm H_2O.Angiography of 99 cases revealed partial recanalization in 75 ca- ses.The circulation time reduced to almost normal in 93 cases.Conclusion Endovascular thrombolytic treatments which consist of injection of urokinase via common carotid artery,direct thrombolysis,stent angioplasty for cerebral venous sinus thrombosis may be effective methods.