【摘要】 目的探讨颅内静脉窦血栓形成的治疗策略。方法回顾性分析天津环湖医院自2004年1月至2009年8月收治颅内静脉窦血栓形成患者共52例,根据症状、体征、腰穿压力以及影像学资料将病情分为轻症及重症,分别接受全身抗凝联合静脉溶栓、全身抗凝联合血管内介入溶栓、钻颅上矢状窦溶栓的治疗,同时均口服华法林并持续6～12个月。结果27例轻症患者接受全身抗凝联合静脉溶栓治疗,14例痊愈,9例好转,4例无效;22例重症患者接受全身抗凝联合血管内介入溶栓,18例痊愈,3例好转,1例死亡;3例重症患者行钻颅上矢状窦溶栓术,均痊愈。结论根据患者症状、体征、腰穿压力以及影像学资料的特点,可将病情分为轻症及重症,针对分型选择不同的方法治疗颅内静脉窦血栓是安全、有效的。更多还原

【Abstract】 Objective To investigate the effective and safe strategies in treatment of cerebral venous sinus thrombosis(CVST). Materials and methods: clinical data of 52 patients diagnosed with cerebral venous sinus thrombosis from Jan,2004 to Aug,2009 were retrospectively analyzed. The patients were subdivided into mitis types and gravis type according to the features of symptoms, signs, lumbar puncture pressure, and imaging. Patients were treated with anticoagulation, intravenous thrombolysis, endovascular thrombolysis, superior sagittal sinus cut-open/intrasinus thrombolysis separately ; all the patients took warfarin for 6 ~ 12 months. Results: 27 cases of mitis type received anticoagulation and intravenous thrombolysis, 14 were cured, 9 were improved and 4 were ineffective; 22 cases of gravis type received anticoagulation and endovascular thrombolysis, 18 were cured, 3 were improved and 1 was dead; 3 cases with gravis type received superior sagittal sinus cut-open/ intasinus thrombolysis and were cured. Conclusion: It is probable to subdivide CST into mitis types and gravis type according to the features of symptoms, signs, lumbar puncture pressure, and imaging; different therapeutic strategies are proved to be safe and effective in treatment of certain type.更多还原