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目的探讨孕产妇颅内静脉窦血栓形成(CVST)的高危因素、临床特点、诊治及预防。方法回顾性分析1997年1月至2007年12月南方医科大学南方医院26例孕产妇CVST患者的临床资料。结果26例患者危险因素以剖宫产术、长期卧床、子前期为主;孕早期7例占26.9%,孕中期2例占7.7%,孕晚期3例占11.5%,产褥期14例占53.8%,以上矢状窦区病灶多见。主要临床表现为头痛;影像学检查为主要诊断方法;以首选抗凝的综合治疗为原则,其显效率61.5%,病死率11.5%,误诊率高达57.7%。结论CVST临床表现缺乏特异性,高危因素众多,误诊率高,确诊有赖于影像学检查,综合治疗为原则,抗凝治疗安全有效,重在预防。
Objective To investigate the risk factors, clinical features, diagnosis, treatment and prevention of intracranial venous sinus thrombosis (CVST) in pregnant women. Methods The clinical data of 26 pregnant women with CVST from January 1997 to December 2007 in Nanfang Hospital of Southern Medical University were retrospectively analyzed. Results The risk factors of 26 patients were cesarean section, long-term bed rest and pre-natal stage. Among them, 7 cases accounted for 26.9% in early pregnancy, 7.7% in second trimester, 11.5% in third trimester and 14 cases in puerperium %, More common lesions of the sagittal sinus area. The main clinical manifestations of headache; imaging examination as the main diagnostic method; the preferred anticoagulant therapy principle, the markedly effective rate of 61.5%, mortality rate of 11.5%, misdiagnosis rate as high as 57.7%. Conclusions The clinical manifestations of CVST are lack of specificity, high risk factors and high misdiagnosis rate. The diagnosis depends on the imaging examination and comprehensive treatment as the principle. The anticoagulant therapy is safe and effective and focuses on the prevention.