颅内静脉窦血栓回顾性临床研究.docVIP

颅内静脉窦血栓回顾性临床研究 何桂香 （江苏省盐城市第三人民医院 盐城214000） 摘要：目的：探讨颅内静脉窦血栓（CVST）形成的危险因素、临床表现、影像学检查、诊治及影响预后的因素等。方法：回顾性分析2010年8月～2016年4月经确诊的30例CVST患者的危险因素、临床表现、脑脊液、头颅CT、MRI、MRV及预后评估等。结果：CVST发病因素较多，部分患者合并多个危险因素；头痛、视物模糊、意识障碍、精神障碍、癫痫等为常见临床表现；头颅MRI+MRV是目前CVST检查最常用的诊断手段，DSA检查为金标准；肝素抗凝安全有效。结论：CVST临床症状多变且无特异性，头痛为主要临床表现，头颅MRV可提高诊断阳性率，DSA检查为金标准；高颅压、局灶性神经功能障碍、脑出血是本病预后不良的独立危险因素。 关键词：颅内静脉窦血栓；危险因素；头痛；抗凝 Retrospective Clinical Research of Intracranial Venous Sinus Thrombosis HE Gui-xiang (The Department of Neurology, the third People’s Hospital of Yancheng, Jiangsu, Yancheng214000) Abstract: Objective: To evaluate the risk factors, clinical manifestations, imaging examination, diagnosis, treatment and the factors influencing prognosis of the formation intracranial venous sinus thrombosis (CVST). Methods: From August 2010 to April 2016, a retrospective analysis on 30 cases of patients with CVST, the risk factors, clinical manifestations, cerebrospinal fluid, cranial CT, MRI, MRV and prognosis were evaluated. Results: There were many pathogenic factors of CVST, some patients merge multiple risk factors; Headache, blurred vision, disturbance of consciousness, mental disorders, epilepsy, etc, as the common clinical manifestations; head MRI and MRV were now the most common methods for diagnosis of CVST check, DSA examination as the gold standard; Heparin anticoagulation was safe and effective. Conclusion: The clinical symptoms of CVST are variable and nonspecific, headache as the main clinical manifestations, cranial MRV can improve the positive rate of diagnosis, DSA examination as the gold standard; high intracranial pressure、focal neurological dysfunction and cerebral hemorrhage were independent risk prognostic factors of the disease. Key words: Intracranial venous sinus thrombosis; Risk factors; Headache; Anticoagulation 中图分类号：R743.33 文献标识码：B 颅内静脉窦血栓形成（CVST）是一种静脉系统的脑卒中，发病率较低，占全部卒中患者的0.5%～1%，好发于年轻女性，男女比例约为1:3[1]；临床表现复杂、多样，易误漏诊，易导致高致残率和死亡率[2]。随着对该病认识逐步深入及神经影像学检查技术不断进步，近年对该病诊断水平逐步提