脑静脉窦血栓形成合并癫痫发作的临床分析

Clinical analysis of cerebral venous sinus thrombosis complicated with epilepsy

目的对脑静脉窦血栓形成合并癫痫发作的临床表现进行探析,分析脑静脉窦血栓形成合并癫痫发作的危险因素以及多种治疗方法对预后的影响。方法60例脑静脉窦血栓形成患者,依据有无合并癫痫发作分为血栓组(25例)及癫痫组(35例)。收集两组患者的临床资料,比较两组患者的临床表现;采用多因素Logistic回归模型分析脑静脉窦血栓形成合并癫痫发作的危险因素;给予两组患者相关治疗,比较两组患者的预后。结果癫痫组患者的意识障碍、运动障碍、语言障碍发生率分别为42.86%、65.71%、45.71%,高于血栓组的16.00%、24.00%、8.00%,差异具有统计学意义(P<0.05);两组患者头疼、头晕、发热、视力障碍发生率比较差异无统计学意义(P>0.05)。癫痫组患者入院时颅内出血占比57.14%、入院时重症占比54.29%、血栓形成于上矢状窦占比62.86%、累及单个静脉窦占比57.14%高于血栓组的24.00%、28.00%、28.00%、20.00%,年龄(56.77±11.38)岁低于血栓组的(66.83±13.51)岁,差异具有统计学意义(P<0.05)。多因素Logistic回归分析显示:入院时颅内出血为脑静脉窦血栓形成合并癫痫发作的独立危险因素(P<0.05)。出院后随访6个月,癫痫组患者死亡4例,均为介入治疗;血栓组患者死亡2例,其中单纯抗凝治疗1例,介入治疗1例。癫痫组患者死亡率11.43%(4/35)与血栓组的8.00%(2/25)比较差异无统计学意义(P>0.05)。结论及时干预颅内出血,可有效减少脑静脉窦血栓形成患者出现癫痫发作情况;对合并癫痫发作的脑静脉窦血栓形成患者进行介入治疗,未必可以明显改善预后。

Objective To explore the clinical manifestations of cerebral venous sinus thrombosis complicated with epilepsy,and analyze the risk factors of cerebral venous sinus thrombosis complicated with epilepsy and the influence of various treatment methods on prognosis.Methods 60 patients with cerebral venous sinus thrombosis were divided into thrombosis group(25 cases)and epilepsy group(35 cases)according to the presence or absence of epilepsy.The clinical data of the two groups were collected,and the clinical manifestations of the two groups were compared.Multivariate Logistic regression model was used to analyze the risk factors of cerebral venous sinus thrombosis complicated with epilepsy;both groups received relevant treatment,and their prognosis was compared.Results The incidence rates of consciousness disorder,movement disorder and language disorder in the epilepsy group were 42.86%,65.71%,and 45.71%,which were higher than 16.00%,24.00%,and 8.00%in the thrombosis group,and the differences were all statistically significant(P<0.05).There was no statistically statistical significance in the incidence of headache,dizziness,fever and visual disturbance between the two groups(P>0.05).In the epilepsy group,the intracranial hemorrhage accounted for 57.14%,severe cases on admission accounted for 54.29%,thrombosis in the superior sagittal sinus accounted for 62.86%,and a single venous sinus was involved in 57.14%,which were higher than 24.00%,28.00%,28.00%,and 20.00%in the thrombosis group;the age was(56.77±11.38)years which was lower than(66.83±13.51)years in the thrombosis group;the differences were all statistically significant(P<0.05).Multivariate Logistic regression analysis showed that intracranial hemorrhage on admission was an independent risk factor for cerebral venous sinus thrombosis complicated with epilepsy(P<0.05).During the 6-month follow-up after discharge,4 patients in the epilepsy group died,all of which were treated with interventional therapy;2 patients in the thrombosis group died,including 1 patient who received anticoagulation alone and 1 patient who received interventional therapy.The mortality rate was 11.43%(4/35)in the epilepsy group,which was not statistically significant compared with 8.00%(2/25)in the thrombosis group(P>0.05).Conclusion Timely intervention in patients with intracranial hemorrhage can effectively reduce the occurrence of epilepsy in patients with cerebral venous sinus thrombosis;interventional therapy for patients with cerebral venous sinus thrombosis complicated with epilepsy may not significantly improve the prognosis.