国际医药卫生导报2018，Vol.24Issue(15)：2230-2233,4.DOI:10.3760/cma.j.issn.1007-1245.2018.15.003
颅内静脉窦血栓形成介入取栓治疗20例临床及影像分析
Analysis of the safety and effectiveness of mechanical thrombectomy in the treatment of cerebral venous sinus thrombosis
摘要
Abstract
Objective To analyze the effectiveness and safety of mechanical thrombectomy in the treatment of cerebral venous sinus thrombosis (CVST).Methods A retrospective review of all CVST cases treated with mechanical thrombectomy between Oct 2007 and Oct 2017 were performed.Clinical and radiological features of the patients,the effectiveness of the surgery,and the relative factors were analyzed.Results A total of 20 patients were included in this study.Main clinical symptoms and signs included headache (20 cases),vomiting (8 cases),epilepsy (6 cases),conscious disturbance (15 cases),limb asthenia (20 cases),and neck rigidity (10cases).Glasgow coma scale core was (12.8+2.2) points before the surgery.Intracerebral hemorrhage (9 cases),cerebral ischemia (8 cases),subarachnoid hemorrhage (6 cases),cerebral hernia signs (2 cases) were found by the radiological evaluation before the surgery.Preoperative venous examination:17 patients completed MRV and DSA both,the range of venous sinus occlusion showed by MRV was more than that by DSA in 12 cases,the sigmoid sinus was not demonstrated by MRV in 9 cases,the straight sinus was not demonstrated in 6 cases,unilateral or bilateral transverse sinus was not demonstrated in 3 cases.The range of venous sinus occlusion showed by DSA was more than that by MRV in 6 cases,including 3 cases of transverse sinus occlusion,1 case of sigrnoid sinus occlusion,1 case of deep venous occlusion,1 case of cerebral venous occlusion.After mechanical thrombectomy,complete or partial revascularization demonstrated by MRV or DSA was achieved in 15 cases,accounting for 75％.There were no statistically significant differences in age of onset,disease duration,main clinical symptoms,medical history,and the distribution of occluded sinus between patients with poor outcome and patients with good outcome (P＞0.05).After the surgery,the whole cerebral circulation time did not significantly change in patients with poor outcome,which was significantly longer than that in patients with good outcome (P＜0.05).Conclusion MRV was less sensitive in detecting deep venous and sinus occlusion.Mechanical thrombectomy was very efficient in the treatment of CVST.The high reflowing rate and short cerebral circulation time after surgery were the main determinants of good outcome.关键词
颅内静脉窦血栓形成/机械取栓术/脑血管造影术Key words
Cerebral venous sinus thrombosis/Mechanical thrombectomy/Digital subtraction angiography引用本文复制引用
杨慧,包泽岩,李志刚,钟水生,梅莉,曾昭龙..颅内静脉窦血栓形成介入取栓治疗20例临床及影像分析[J].国际医药卫生导报,2018,24(15):2230-2233,4.基金项目
广东省医学科学技术研究基金项目(B2015141) （B2015141）
广东省自然科学基金-自由申请(2014A030313634)Medical Science and Technology Research Fund Program of Guangdong Province (B2015141) （2014A030313634）
Natural Science Foundation of Guangdong Province (2014A030313634) （2014A030313634）
