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目的探讨低分子肝素钙针治疗颅内静脉窦血栓形成合并出血的临床疗效。方法回顾性分析15例颅内静脉窦血栓形成合并出血的患者的临床资料。这15例患者入院后均经过头颅CT、MRI、MRV扫描检查明确诊断为颅内静脉窦血栓形成,同时合并有脑实质内的不同程度出血。所有患者在治疗上常规给予甘露醇脱水降低颅内压、治疗癫痫及肺部感染等合并症的基础上给予低分子肝素钙针皮下注射治疗10天疗程。结果所有15例患者痊愈14例,无神经系统后遗症,随访1年未复发。1例疗程结束后仍有癫痫发作和单眼视物变形,给予抗癫痫药物维持治疗25周,期间未见癫痫发作,随访1年未见血栓复发。结论低分子肝素钙针皮下注射抗凝治疗颅内静脉窦血栓形成合并出血并未增加脑出血风险,具有显著的疗效和较高的安全性。
Objective To investigate the clinical effect of low molecular weight heparin calcium needle in the treatment of intracranial venous sinus thrombosis with hemorrhage. Methods The clinical data of 15 patients with intracranial venous sinus thrombosis and hemorrhage were retrospectively analyzed. All 15 patients were diagnosed as intracranial venous sinus thrombosis by CT, MRI and MRV scan after admission, and combined with varying degrees of intracranial hemorrhage. All patients in the treatment of conventional mannitol dehydration to reduce intracranial pressure, treatment of epilepsy and pulmonary infection and other complications based on the given low molecular weight heparin calcium needle subcutaneous injection for 10 days course of treatment. Results All 15 patients were cured in 14 cases without neurological sequelae and had no recurrence after one year of follow-up. One patient still had epileptic seizures and monocular retinal deformities after the course of treatment. Anti-epileptic drugs were given for 25 weeks. No seizure was found during the follow-up period, and no recurrence of thrombus was observed in one year follow-up. Conclusion Low molecular weight heparin injection of subcutaneous anticoagulant therapy for intracranial venous sinus thrombosis with bleeding did not increase the risk of cerebral hemorrhage, with significant efficacy and high safety.