52例颅内静脉窦血栓的临床分析

Clinical analysis of 52 cases of intracranial venous sinus thrombosis

目的探讨颅内静脉窦血栓形成的临床特征及诊治策略。方法回顾性分析我院2002年1月至2009年11月共52例CVST患者的发病年龄、发病形式、临床表现、影像学特征、诊疗方案及预后情况。结果本组男性29人,女性23人。年龄21-73岁,多数为亚急性起病,临床表现为头痛、意识障碍、癫痫、偏瘫等。其中单纯肝素抗凝治疗37例(71.2%),肝素联合静脉窦内溶栓治疗11例(21.2%),肝素联合颈动脉穿刺溶栓治疗3例(5.7%),单纯动脉穿刺溶栓治疗1例(1.9%)。结论 CVST的临床表现缺乏特异性;血D-二聚体对CTST诊断有参考作用,头部CT及CTV有助于早期诊断;治疗以持续静脉注射肝素抗凝为主,必要时可联合介入溶栓治疗,及早诊断及早治疗是救治关键。

Objective To study the clinical characteristics and the strategies of cerebral venous sinus thrombosis.Methods We analysised retrospectively 52 cases of the CVST patients in our hospital from January 2002 to November 2009,including onset age,disease forms,clinical manifestations,imaging characteristics,treatment options and prognosis.Results There＇re 29 male and 23 female in this group,aged from 21 to 73 years old,most of whom were subacute onset,with clinical manifestations of headache,disturbance of consciousness,seizures,paralysis,and etc.Anticoagulant therapy with iv heparin alone were given in 37 cases（71.2%）,anticoagulant therapy combined with intravenous sinus thrombolysis in 11 cases（21.2%）,anticoagulant therapy combined with intrartery thrombolytic therapy in 3 cases（5.7%）,intrartery thrombolysis alone in 1 cases（1.9%）.Conclusion The clinical manifestations of CVST is lack of specificity;blood D-dimer can be referred in the diagnosis of the CTST,head CT and CTV will contribute to early diagnosis;continuous intravenous heparin anticoagulation is the chief treatment,and combined with interventional thrombolysis therapy when necessary,early diagnosis and early treatment are importent to the outcome.