中国脑血管病杂志2012，Vol.9Issue(12)：625-628,672,5.DOI:10.3969/j.issn.1672-5921.2012.12.003
抗凝与血管内机械碎栓治疗颅内静脉窦血栓形成的疗效观察
Clinical observation of anticoagulation and endovascular mechanical thrombectomy in the treatment of cerebral venous sinus thrombosis
摘要
Abstract
Objective To compare the safety and efficacy of endovascular mechanical thrombectomy and anticoagulation alone in the treatment of cerebral venous sinus thrombosis (CVST). Methods A total of 137 patients with CVST were enrolled in this study, among them, 75 patients were treated with (low molecular weight heparin 0. 4 mL injection, twice a day, for 3 to 23 days, then oral warfarin for 12 months. 62 patients were treated with mechani thrombectomy. 40 of them were treated in combination with contact thrombolytic therapy. Postoperative drug treatment was the same as the anticoagulation alone group. The safety and efficacy of both groups were compared. Results ①Before treatment, the patients with neurological deficit, status epilepticus seizures, drowsiness/coma, and hemorrhage/infarction in the mechanical thrombectomy group were more than those in the anticoagulation alone group. The modified Rankin scale (mRS) score was higher than that in the anticoagulation alone group (3.1 ±1.0 vs. 2. 1 ±0. 8; all P < 0.05). ②After treatment, the clinical symptoms were improved in the patients of both groups. Before discharge, the mRS score in the mechanical thrombectomy group was lower than that in the anticoagulation alone group (1.1 ±0.4 vs. 1. 6 ± 0. 3 ; P < 0. 05 ). Eighteen patients (24. 0% ) in the anticoagulation alone group still had increased intracranial pressure, and 10 of them (13.3%) had optic disc edema; 12 patients ( 19. 4% ) in mechanical thrombectomy group had increased intracranial pressure, and 8 (12.9% ) had optic disc edema (P >0. 05). ③One patient died in each group. There were 4 patients with intracerebral hemorrhage in the mechanical thrombectomy group before procedure, and their hematoma enlarged and symptoms got worse. One of them died of brain herniation because of refusing surgery. ④ 62 patients in the anticoagulation alone group and 56 in the mechanical thrombectomy group were followed up for 1 to 5 years. Six patients in the anticoagulation alone group and 4 in the mechanical thrombectomy group still had symptoms of intracranial hypertension. They were improved after continuous anticoagulation. Conclusion The patients in the mechanical thrombectomy group has severer clinical symptoms cal than those in the anticoagulation alone group, but the prognosis is better than those in the anticoagulation alone group.关键词
窦血栓形成,颅内/抗凝/机械碎栓Key words
Sinus thrombosis, intracranial/ Anticoagulant/ Mechanical thrombectomy引用本文复制引用
李广文,曾现伟,季泰令,李思颉,凌锋,吉训明..抗凝与血管内机械碎栓治疗颅内静脉窦血栓形成的疗效观察[J].中国脑血管病杂志,2012,9(12):625-628,672,5.基金项目
"十一五"国家科技支撑计划项目(2011BAI08B07) （2011BAI08B07）
