【摘要】：目的分析比較156例確診為顱內(nèi)靜脈竇血栓形成患者的臨床及影像學(xué)特征。收集所有入組患者的臨床及影像學(xué)資料,并對(duì)繼發(fā)腦實(shí)質(zhì)損傷患者可能存在的相關(guān)因素(如性別,年齡,平均住院時(shí)間,起病急緩,已知病因,臨床表現(xiàn)差異,實(shí)驗(yàn)室檢查結(jié)果,血栓累及靜脈竇部位、數(shù)目和短期預(yù)后等情況)進(jìn)行統(tǒng)計(jì)學(xué)分析比較。為提高靜脈竇血栓形成患者的臨床診療水平。方法回顧性分析所有入組的156例患者的臨床資料,并根據(jù)顱腦CT或MRI影像學(xué)檢查結(jié)果,分為腦實(shí)質(zhì)病灶陽(yáng)性組(82例)和陰性組(74例),比較分析兩組患者的一般情況、病因、臨床表現(xiàn)、影像學(xué)檢查、受累靜脈竇及短期預(yù)后的差異。結(jié)果兩組患者單因素比較,顱內(nèi)靜脈系統(tǒng)血栓形成的病因主要為感染、妊娠、血液系統(tǒng)疾病及代謝、自身免疫性疾病等,陽(yáng)性組血液系統(tǒng)疾病(包括貧血、血小板增多或減少、白血病、MDS等)患者居多,陰性組患者繼發(fā)于局部感染及術(shù)后脫水患者居多;在臨床表現(xiàn)方面,陽(yáng)性組發(fā)生癲癇、意識(shí)障礙、精神癥狀、神經(jīng)功能缺損(包括單側(cè)運(yùn)動(dòng)障礙、中樞性面舌癱、言語(yǔ)功能障礙)、查體示病理征陽(yáng)性的比率均高于陰性組,均有顯著性差異(P0.05);據(jù)統(tǒng)計(jì),陽(yáng)性組血栓形成發(fā)生于上矢狀竇的比率低于陰性組(?2=4.480,P=0.034);DSA檢查可發(fā)現(xiàn)MRV不能明確的病因,如動(dòng)靜脈畸形、先天性靜脈及靜脈竇發(fā)育不良等;出院時(shí)陽(yáng)性組癥狀完全恢復(fù)(改良Rankin評(píng)分0~2分)的比率低于陰性組(?2=19.765,P=0.000);二元多因素Logistic回歸分析示陽(yáng)性組患者意識(shí)障礙更重,累及上矢狀竇者更少,短期預(yù)后更差。結(jié)論1、顱內(nèi)靜脈系統(tǒng)血栓形成的病因主要為感染、妊娠、血液系統(tǒng)疾病及代謝、自身免疫性疾病等;且合并血液系統(tǒng)疾病患者更容易累及腦實(shí)質(zhì)損傷。2、DSA檢查可發(fā)現(xiàn)MRV檢查不能明確的腦血管畸形及靜脈竇先天發(fā)育不良等潛在病因,對(duì)此病的病因?qū)W診斷意義重大,還可以了解管腔閉塞程度及側(cè)支循環(huán)建立情況,建議臨床有條件者應(yīng)盡量積極行DSA檢查。
[Abstract]:Objective to analyze and compare the clinical and imaging features of 156 patients with intracranial venous sinus thrombosis. The clinical and imaging data of all the patients were collected, and the possible related factors (such as sex, age, average hospitalization time, onset of onset, known etiology, clinical manifestation differences, laboratory examination results, thrombus involved in venous sinus, number and short-term prognosis) were statistically analyzed and compared among the patients with secondary brain parenchyma injury (such as sex, age, average hospitalization time, onset of onset, known etiology, clinical manifestation difference, laboratory examination results, thrombus involved in venous sinus, number and short-term prognosis, etc.). In order to improve the clinical diagnosis and treatment of patients with venous sinus thrombosis. Methods the clinical data of all patients were analyzed retrospectively. according to the results of CT or MRI imaging examination, they were divided into positive group (82 cases) and negative group (74 cases). The general situation, etiology, clinical manifestations, imaging examination, involved venous sinus and short-term prognosis of the two groups were compared and analyzed. Results the main causes of intracranial venous thrombosis were infection, pregnancy, blood system disease and metabolism, autoimmune diseases and so on. Most of the patients in the positive group had blood system diseases (including anemia, platelet increase or decrease, leukemia, MDS, etc.), and most of the patients in the negative group were secondary to local infection and postoperative dehydration. In terms of clinical manifestations, seizures, disturbance of consciousness, mental symptoms and neurological defects (including unilateral motor disorder, central facial tongue paralysis, speech dysfunction) in the positive group were significantly higher than those in the negative group (P < 0.05). According to statistics, the incidence of thrombosis in the superior sagittal sinus in the positive group was lower than that in the negative group (? 2: 4.480, P 鈮，

本文編號(hào)：2504112