22例颅内静脉窦血栓形成临床研究.docVIP

22例颅内静脉窦血栓形成临床研究【摘要】 目的 加深对脑静脉血栓形成的认识、提高诊疗水平。 方法 回顾性分析南方医科大学附属珠江医院22例脑静脉血栓形成病例的年龄、病因、临床症状、实验室及影像学资料、治疗方法。 结果 22例患者中，男：女比例1∶1；年龄自16岁到61岁；临床症状以头痛最为常见，可伴发呕吐、视乳头水肿、癫痫、肢体偏瘫、语言障碍、动眼神经麻痹等局灶性神经功能损害及意识障碍；影像学检查可采用MRV/DSA/CTV，血栓累及侧窦、上矢状窦最常见，且常合并累及多个静脉/静脉窦；经抗凝、降颅压、对症等治疗，有 20例症状缓解，复查提示原来血栓形成的静脉/静脉窦不同程度的再通； 2例病情加重，其中1例死亡。 结论 颅内静脉窦血栓形成病因多种，发病形式多样，临床表现无特异性，随着磁共振MRV、CTA、DSA的应用，脑静脉血栓形成的诊断已不是难题，且治疗效果较好；另外神经介入治疗值得关注与期待。 【关键词】 颅内静脉窦血栓；分析；诊断及治疗 22 cases of intracranial venous sinus thrombosis in clinical analysis HUANG Han-ning， XIE Hui-fang， HUANG Dan-dan，et al.Gaozhou People’s Hospital，Gaozhou，525200，China 【Abstract】 Objective To deepen understanding of cerebral venousand sinus thrombosis, improve our diagnosis and therapy. Methods Analyzed the datas of 22 patients from Zhuiang Affilated Hospital of Southern Medical University, included age, causes, clinical symptoms, the datas of laboratory and imaging, and therapeutic regimen. Results Male-to-female ratio was 1∶1, aging from 16 to 61.The most common symptom was headache. The concomitant symptoms included vomiting, papilloedema, epilepsy, paralysis, language disorders and so on, which were focal neurologic impairment, oculomotor paralysis, consciousness disorders. Imaging examine include MRV, DSA and CTV. The most common thrombosis is in transverse sinus and superior sagittal sinus, and often involved several venous and sinus. After the therapy of anticoagulation, decreased intracranial pressure and so on, 20 patients acquired symptomatic relief, whose imaging review showed the venous or sinus had varying degrees of recanalization.2 patients’ conditions aggravated, one of whom was dead in the end. Conclusion CVST has different kinds of causes and various types of onset. And there is no unique clinical manifestation for CVST. Along with the application of MRV，CTA and DSA, the diagnosis of CVT is not difficult. And we get a good treatment effect. In addition, interventional neuroradiology should be paid more attention and be wo