摘要
目的探讨孕产妇合并颅内静脉窦血栓形成(CVST)的临床和影像学特点、诊治及预防。方法回顾性分析32例孕产期颅内静脉窦血栓形成患者病历资料。结果 32例患者分布为早期妊娠4例、中晚期妊娠5例、产褥期23例,剖宫产、感染因素和重度子痫前期是主要发病诱因;首发症状27例(84.4%);早期头颅CT 13例,5例未检出病变,29例头颅MRI+MRV检查确诊。确诊后给予积极治疗诱因和低分子肝素抗凝等治疗,11例病人介入微导管尿激酶局部灌注,死亡4例(12.5%),3例(9.4%)遗留轻偏瘫。结论孕产期颅内静脉窦血栓形成以产褥期多发,早期临床症状无特异性,以慢性颅内压增高症状为主。头颅MRI+MRV诊断符合率高,及早控制危险因素及抗凝、介入溶栓有较好的疗效。
Objective To study the clinical and imaging features ,the diagnosis ,treatment and prevention of cerebral venous sinus thrombosis （CVST ） during pregnancy and puerperium .Methods A retrospective study was performed in 32 cases of pregnant women with CVST .Results There were 4 cases of early preg-nancy ,5 cases of midtremester and late pregnancy and 23 cases of puerperium .The primary inducements MRV .The treatment included removing induced factors and low molecular heparin anticoagulation in all confirmed CVST cases .11 cases were treated with local infusion of urokinase by interventional catheter ,3 cases （9 .4% ） remained in hemiparesis and 4 cases （12 .5% ） died .Conclusion Maternal CVST is common in puerperium ,and no early clinical specificity can be found .The main initial symptom is intracranial hy-pertension .M RI and M RV can produce high accordance rate .Early control of risk factors ,anticoagulant therapy and interventional thrombolytic therapy are effective in treating CVST.
出处
《山东医学高等专科学校学报》
2014年第5期346-348,共3页
Journal of Shandong Medical College
关键词
孕产妇
颅内静脉窦血栓形成
诊断
预防
Pregnant and parturient women
Thrombosis of intracranial venous sinus
Diagnosis
Pre-vention
