颅内静脉窦血栓形成的诊治分析

Clinical analysis of strategies of the diagnosis and treatment of cerebral venous sinus thrombosis

目的 探讨颅内静脉窦血栓形成（CVST）诊断及治疗方法。方法 回顾性分析18例CVST的临床资料,根据临床表现、闭塞程度及侧支循环情况,10例接受单纯全身抗凝药物治疗,6例行单纯静脉溶栓,2例行全身抗凝＋血管内溶栓治疗。结果 出院后随访6～23个月,平均12个月。单纯全身抗凝药物治疗的10例中,改良Rankin量表（mRS）评分0分6例,1分2例,3分2例。单纯静脉溶栓的6例中,mRS评分0分4例,1分1例,2分1例。全身抗凝＋血管内溶栓治疗的2例中,mRS评分0分1例,3分1例。结论 CVST应根据临床表现、闭塞程度及侧支循环开放程度进行评估,从而选择个性化治疗方案。

Objective To discuss the clinical characteristics and the selection of diagnosis and treatment of cerebral venous sinus thrombosis （CVST）. Methods The clinical data of 18 patients with CVST were analyzed retrospectively. Of 18 patients, 10 received systemic anticoagulant therapy, 6 intravenous thrombolytic therapy, and 2 systemic anticoagulant therapy and endovascular thrombolysis. Results Of 10 patients receiving systemic anticoagulant therapy, 6 were cured and 4 improved. Of 6 patients receiving intravenous thrombolytic therapy, 4 were cured and 2 improved. Of 2 patients receiving systemic anticoagulant therapy and endovascular thrombolysis, 1 was cured and 1 improved in the symptoms. The cerebral vein sinuses occluded by thrombosis were recanalized completely or in great part in all the patients after the treatment. There was no thrombosis again during the following up from 6 to 23 months in all the patients. Conclusion The individualized treatment should be selected according to the clinical manifestations and extents of occlusion of cerebral vein sinus and collateral circulation in the patients with CVST.