血管内多方式联合治疗重型颅内静脉窦血栓形成的临床观察

来源:用户上传      作者:李水仙?阳清伟?陈良义?陈中杰?王蓉?李隆龄?陈星宇

　　【摘要】 目的 u价以球囊碎栓、中间导管抽吸为基础的血管内多方式联合治疗重型颅内静脉窦血栓形成的有效性、安全性及预后。方法 收集采用球囊碎栓、中间导管抽吸为基础的血管内多方式联合治疗的13例重型颅内静脉窦血栓形成患者的临床资料，记录术前与术后1周GCS评分、Barthel指数评分，术后6个月改良Rankin量表（mRS） 评分、脑部磁共振静脉成像或DSA检查结果。结果 例1患者上矢状窦及双额顶支静脉部分再通，例9患者右横窦、乙状窦部分再通;例7、例13患者左横窦、左乙状窦慢性闭塞未开通而其余静脉窦完全再通;其他9例患者完全再通。术后1周GCS评分、Barthel指数评分均高于术前（P均< 0.05）。患者术中和术后未出现与介入相关的并发症。术后随访6个月，10例患者预后良好（mRS评分0～2分）、9例患者的静脉窦完全通畅。结论 以球囊碎栓、中间导管抽吸为基础的血管内多方式联合治疗重型颅内静脉窦血栓形成，有效、安全，预后较好。
　　【关键词】 球囊碎栓;中间导管抽吸;血管内联合治疗;重型颅内静脉窦血栓形成
　　Clinical observation of intravascular multi-mode combined therapy for severe cerebral venous sinus thrombosis Li Shuixian， Yang Qingwei， Chen Liangyi， Chen Zhongjie， Wang Rong， Li Longling， Chen Xingyu. Department of Neurology，Zhongshan Hospital of Xiamen University， Xiamen 361004， China
　　Corresponding author， Chen Xingyu， E-mail： 1925163584@qq.com
　　【Abstract】 Objective To evaluate the efficacy， safety and prognosis of intravascular multi-mode combined therapy based on balloon-assisted thrombolysis and intermediate catheter aspiration for severe cerebral venous sinus thrombosis. Methods Clinical data of 13 patients with severe cerebral venous sinus thrombosis treated with intravascular multi-mode combined therapy based on balloon-assisted thrombolysis and intermediate catheter aspiration were retrospectively analyzed. Glasgow coma score （GCS） and Barthel index score before and 1 week after operation were recorded. Clinical prognosis was evaluated by modified Rankin scale （mRS） and recanalization of occlusion was evaluated by brain magnetic resonance venography （MRV） or digital subtraction angiography （DSA）. Results In case 1， the occlusion of the superior sagittal sinus and double frontal top branch veins was partially recanalized. In case 9， the occlusion of the right transverse sinus and sigmoid sinus was partially recanalized. In case 7 and case 13， chronic occlusion of the left transverse sinus and left sigmoid sinus was not recanalized， whereas the other venous sinuses were completely recanalized. The remaining 9 patients achieved complete recanalization. The GCS and Barthel index score at postoperative 1 week were significantly higher than those before operation （both P < 0.05）. No intervention-induced complications occurred intraoperatively or postoperatively. During postoperative 6-month follow-up， favorable outcomes （mRS≤2） were achieved in 10 patients and complete recanalization was obtained in 9 patients. Conclusion Intravascular multi-mode combined treatment based upon balloon thrombolysis and intermediate catheter aspiration is efficacious and safe for severe intracranial venous sinus thrombosis， which yields high clinical prognosis.
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