妊娠不同阶段并发颅内静脉血栓形成的临床特征

Clinical Features of Cerebral Venous Thrombosis during Different Periods of Pregnancy

目的:探讨妊娠不同阶段与颅内静脉血栓形成(CVT)的发病机制、临床特征。方法:收集妊娠及产后并发静脉窦血栓形成患者34例的临床资料,分析妊娠并发CVT的临床特征,复习相关文献。结果:本组34例患者中,妊娠期20例,产褥期14例,平均发病年龄为(26.4±4.1)岁。通常急性起病,数天内达高峰,头痛、癫痫发作、意识障碍为最常见的临床症状。妊娠剧吐、产褥感染、妊高症、剖宫产术并发症、贫血以及低蛋白血症均为妊娠并发CVT的危险因素。D-D二聚体异常及颅内静脉血管造影检查为诊断的金标准。及早诊断、尽早抗凝是治疗的关键。结论:妊娠不同时期均可发生CVT。

Objective：To investigate the pathogenesis and clinical features of cerebral venous thrombosis （CVT） during different periods of pregnancy.Methods：Clinical data of 34 pregnant and postpartum patients diagnosed as CVT were collected.The related literature to summary risk factors,treatment and prevention measures of CVT in different periods were reviewed.Results：There are 34 cases with CVT,including 20 pregnant and 14 postpartum women.Average age of onset was （26.4±4.1） years old.Headaches,seizures,disturbances of consciousness were the most common clinical symptoms with acute onset.Hyperemesis gravidarum,puerperal infections,pregnancy-induced hypertension,caesarean birth complications,anemia and hypo-albuminemia were the risk factors for pregnancy complicated with CVT.D-dimer in combination with venous angiography was the golden diagnostic standard.Earlier diagnosis and anticoagulation therapy were the key treatment.Conclusion：CVT could occur during all periods of pregnancy.