颅内静脉窦血栓形成的抗凝治疗临床分析

Observation of the therapeutic effect of anticoagulation on intracranial venous sinus thrombosis

目的探讨颅内静脉窦血栓形成（CVST）的抗凝治疗效果。方法回顾分析我院2006-01—2013-10收治的124例CVST患者资料,其中病程≤8.5d者64例,病程〉8.5d者60例。所有患者接受抗凝治疗,采用普通肝素或低分子肝素0.4mL（5000U）皮下注射,用量2次/d,q12h;持续3-23d（平均12d）。比较治疗前后症状表现、腰穿结果,评估临床疗效,同时比较早期抗凝与晚期抗凝的效果。结果除言语障碍外,出院时患者各项主要症状的发生率均低于病程中发生率,差异均有统计学意义（P〈0.05）。其中37例患者进行腰穿初查及复查,复查时平均颅内压（260.24±64.79）mmH2O,低于初次腰穿颅内压（318.75±69.46）mmH2O,差异有统计学意义（P〈0.05）。总有效率90.32%,其中中早期抗凝痊愈率（71.88%）高于晚期（23.33%）（P〈0.05）。结论对CVST采用抗凝治疗安全有效,早期抗凝比晚期痊愈率高。

Objective To investigate the clinical effect of the anticoagulation on intracranial venous sinus thrombosis. Methods Clinical data of 124 patients who were diagnosed in our hospital from Jan 2006 to Oct 2013 were retrospectively ana lyzed, including 64 cases in early stage （course of disease≤8.5 days） and 60 cases in advanced stage（course of disease〉8. 5 days）; 124 cases were treated with anticoagulation therapy. The symptoms and lumbar puncture index before and after treatment were compared. The treatment effect was observed, and the effects of anticoagulation at early stage and advanced stage were compared. Results When the patients were discharged, the incidence rates of all symptoms except speech disorders were lower than those during treatment （P〈0.05）. After treatment, the ICP was decreased compared with that before treatment （P 〈0.05）. The effective rate of the patients was 90.32 %. The recovery rate of anticoagulation in early stage （71.88%）was higher than that in advanced stage（23.33%, P〈0.05）. Conclusion Anticoagulation on intracranial venous sinus thrombosis is ef fective and safe; it is more effective in earlv stage.