脑静脉窦血栓形成的全身抗凝治疗与局部溶栓治疗疗效比较

Comparison of body anticoagulation and local thrombolysis therapy in patients with cerebralvenous sinus thrombosis

目的探讨全身抗凝治疗与局部溶栓治疗对脑静脉窦血栓形成的疗效差异。方法选择井冈山大学附属医院神经内科自2008年1月至2011年10月收治的脑静脉窦血栓形成患者共42例，根据治疗方式不同分为2组：全身抗凝治疗组及局部溶栓治疗组，每组各21例。对比2组患者NIHSS评分、mRS评分、溶栓后造影及不良反应情况。结果全身抗凝治疗组患者神经功能缺损改善率为33．4％，明显低于局部溶栓治疗组的61．9％，差异有统计学意义（P〈0．05）。局部溶栓治疗组患者mRS评分明显低于全身抗凝治疗组，差异有统计学意义（P〈0．05）。2组患者均行溶栓后造影复查，局部溶栓治疗组患者完全再通率明显高于全身抗凝治疗组，差异有统计学意义（P〈0．05）。结论局部溶栓治疗较全身抗凝治疗更有利于脑静脉窦血栓形成患者神经系统功能缺损的改善，有助于神经功能的恢复。

Objective To investigate the healing effect of body anticoagulation and local thrombolysis therapy on patients with cerebral venous sinus thrombosis （CVST）. Methods Forty two patients with CVST, admitted to our hospital from January 2008 to September 2011, were selected; these patients were divided into body anticoagulation group （n=21） and local thrombolysis group （n=21） according the treatment methods. The National Institutes of Health Stroke Scale （NIHSS） scores, modified Rankin Scale （mRS） scores, angiography imaging and adverse reactions after the treatments were compared between the two groups. Results The nervous system function defect improvement in the body anticoagulation group （33.4%） was significantly lower than that in the local thrombolysis group （61.9%, P〈0.05）. The mRS scores in the local thrombolysis group was significantly lower than those in the body anticoagnlation group （P〈0.05）. Angiography after treatment showed that the completely recanalization rate in the local thrombolysis group was significantly higher than that in the body anticoagulation group （P〈0.05）. Conclusion Local thrombolysis, enjoying better effect on nervous system function defect improvement than body anticoagulation, can help the nerve function recovery.