本文選題：顱內(nèi)靜脈系統(tǒng)血栓形成 + 危險因素��； 參考：《吉林大學》2017年碩士論文

【摘要】：目的:通過探討顱內(nèi)靜脈系統(tǒng)血栓形成患者的可能的危險因素、臨床特點、影像學特征、實驗室檢查、治療措施及預后,旨在提高對CVST的認識,使CVST患者能得到盡早診斷及恰當?shù)闹委?改善預后。方法:回顧性分析臨床確診的99例CVST患者的住院病歷,詳細記錄患者的人口統(tǒng)計學數(shù)據(jù)(性別、年齡)、起病形式、危險因素、首發(fā)癥狀、臨床表現(xiàn)、影像學表現(xiàn)、實驗室檢查、治療情況及預后,并對上述臨床資料進行系統(tǒng)的綜合分析和總結。結果:(1)99例CVST患者中男性與女性的比例為1:1.36;(2)患者發(fā)病年齡在13~82歲之間,平均年齡為37.59±15.73歲,20~49歲71例(71.72%);(3)急性起病45例(45.46%),亞急性起病44例(44.44%),慢性起病10例(10.10%);(4)顱內(nèi)壓增高71例(71.72%);神經(jīng)功能缺失癥狀32例(32.32%);腦病樣癥狀37例(37.37%);(5)79(79.80%)例患者存在多個靜脈竇同時受累(≥2個部位),其中橫竇68例(68.69%),乙狀竇57例(57.58%),上矢狀竇56例(56.57%);(6)99例行頭CT檢查,腦靜脈性梗死3例(3.03%),腦實質(zhì)出血10例(10.10%),蛛網(wǎng)膜下腔出血7例(7.07%),腦實質(zhì)出血伴梗死2例(2.02%),腦腫脹或腦積水2例(2.02%);93例行頭MRI檢查,90例行頭MRV檢查,均在頭MRI檢查和(或)在頭MRV檢查中發(fā)現(xiàn)異常,MRI主要表現(xiàn)為不同時期的血栓信號以及腦實質(zhì)病變,MRV主要表現(xiàn)為靜脈竇不顯影或其管腔內(nèi)出現(xiàn)不規(guī)則充盈缺損;7例行DSA檢查,主要表現(xiàn)為竇內(nèi)管腔變細甚至閉塞,管腔內(nèi)信號不均;3例行3D VISTA檢查,提示有相應部位靜脈竇血栓形成;(7)腰穿檢查者87例,68例(78.16%)壓力高于正常,腦脊液白細胞升高31例(35.63%),蛋白升高36例(41.38%),有紅細胞者39例(44.83%),糖、氯化物均正常;50例患者檢測了同型半胱氨酸水平,20例(40%)升高;55例患者檢測了雌激素水平,10例(18.18%)升高,且均為男性患者;66例患者檢測了D-二聚體水平,60例(90.91%)升高;(8)本研究99例患者中,院內(nèi)治愈51例,有效37例,無效11例。結論:(1)臨床上需注意易被忽視的CVST危險因素:高同型半胱氨酸血癥、男性患者雌激素升高、低顱壓綜合征。(2)磁共振VISTA序列是診斷CVST較好的影像學檢查手段。(3)D-二聚體檢測對CVST診斷具有重要價值。(4)CVST的治療應采取抗凝、病因及對癥支持治療為主的綜合治療,如果病情惡化,可采取血管內(nèi)介入治療。
[Abstract]:Objective: to explore the possible risk factors, clinical features, imaging features, laboratory examination, treatment and prognosis of patients with intracranial venous thrombosis in order to improve the understanding of CVST. So that CVST patients can get early diagnosis and appropriate treatment to improve the prognosis. Methods: the medical records of 99 patients with CVST were retrospectively analyzed. The demographic data (sex, age, onset, risk factors, initial symptoms, clinical manifestations, imaging findings, laboratory examination) were recorded in detail. Treatment and prognosis, and the above-mentioned clinical data were systematically analyzed and summarized. Results the male to female ratio of 99 patients with CVST was 1: 1.36%) the age of onset was between 13 and 82 years old. The mean age was 37.59 鹵15.73 years / 2049 years old 71 cases (71.722t) 45 cases with acute onset, 44 cases with subacute onset, 44 cases with subacute onset, 10 cases with chronic onset, 71 cases with increased intracranial pressure (71.722); 32 cases with lack of nerve function (32.32%); 37 cases with encephalopathy like symptoms (37.377,7979.80); The sinus was involved at the same time (鈮，

本文編號：1790200