肝素治疗颅内静脉窦血栓形成13例临床分析

目的探讨肝素治疗颅内静脉窦血栓形成(CVST)的方法、疗效和安全性。方法对13例CVST患者使用肝素进行治疗,监测治疗过程中APTT和PT的变化,调整肝素用量,并观察治疗前后临床症状,影像学的改变。结果CVST的患者中,发病前多数有感染病史;颅内压增高及癫痫发作的症状为主要临床表现;CT表现脑内多发的出血灶;MR、IMRA可显示血栓部位和程度;采用肝素抗凝治疗并使用华法令维持治疗,部分患者血管再通,除一例死亡外,其余12例均痊愈出院。结论发病前感染与本病发生有关;MR、IMRA为确诊该病主要手段;肝素抗凝治疗显示良好疗效,且安全性好。

Objective To investigate the method,effect and safe of Heparin in the treatment of cerebral venous sinus thrombosis（ CVST）, and method, therapeutic effect by Heparin therapy. Methods 13 CVST patients were treated by Heparin, monitor APTT and PT, adjust the Heparin dosis, and observe the clinical symptom,change of imageology between prior treatment and post-treatment. Results CVST patients have been infected before invasion, the major clinical manifestation of the patients were intracranial hypertension and epileptic seizure, CT of patients displayed multiple hemorrhagic, MRI and MRA may displayed location and degree of thrombus, blood vessel of patients who were treated by Heparin anticoagulation and maintenance therapy Warfarin were recanalization, 12 patients were recorered except 1 patient died. Conclusion Primary disease related with infection before invasion, MRI and MRA are major methods to final diagnosis;it is well therapeutic effect and well safety by heparin anticoagulant therapy.