CAJ | 학술논문

目的比较血管内治疗与单纯抗凝治疗颅内静脉(窦)血栓(CYST)的疗效. 方法哈尔滨市第一医院神经外科自1998年1月至2008年12月收治42例CVST患者,其中21例应用单纯抗凝治疗,21例应用血管内治疗.治疗后3 d观察患者颅内压(ICP)下降情况,治疗前、后(3 d及3、6、12个月)通过目测类比法(VAS)检测患者的头痛程度.结果治疗后患者ICP均下降,血管内治疗组除1例患者ICP由术前620 mm H_2O降至410 mm H_2O,其余患者ICP基本稳定在200～260mmH_2O.单纯抗凝治疗组患者1例ICP降至350mmH_2O,5例ICP在400mmH_2O以上,脑疝死亡1例.治疗后3 d、3个月时血管内治疗组和单纯抗凝治疗组患者VAS评分(3 d:8.1±1.6vs3.5±1.5:3个月:4.9±1.4 vs 2.2±1.3)差异均有统计学意义(P<0.05).结论应用血管内治疗CVST能够较快的缓解患者的主要症状并改善患者的预后,较为可靠和安全.
목적 비교혈관내치료여단순항응치료로내정맥(두)혈전(CYST)적료효. 방법 합이빈시제일의원신경외과자1998년1월지2008년12월수치42례CVST환자,기중21례응용단순항응치료,21례응용혈관내치료.치료후3 d관찰환자로내압(ICP)하강정황,치료전、후(3 d급3、6、12개월)통과목측류비법(VAS)검측환자적두통정도.결과 치료후환자ICP균하강,혈관내치료조제1례환자ICP유술전620 mm H_2O강지410 mm H_2O,기여환자ICP기본은정재200～260mmH_2O.단순항응치료조환자1례ICP강지350mmH_2O,5례ICP재400mmH_2O이상,뇌산사망1례.치료후3 d、3개월시혈관내치료조화단순항응치료조환자VAS평분(3 d:8.1±1.6vs3.5±1.5:3개월:4.9±1.4 vs 2.2±1.3)차이균유통계학의의(P<0.05).결론 응용혈관내치료CVST능구교쾌적완해환자적주요증상병개선환자적예후,교위가고화안전.
Objective To compare the efficacy of interventional thrombolysis and anticoagulation therapy alone on patients with cerebral venous sinus thrombosis (CVST). Methods Forty-two patients were diagnosed as having CVST by clinical data. They were divided into anticoagulation therapy group (group A, n=21) and interventional treatment group (group B, n=21). The descent of intracranial pressure (ICP) was detected 3 d after the treatment; the present symptoms of the patients were scored by visual analog scale (VAS) at different time points (before, 3 d and 3, 6 and 12 months after the treatment). Results The level of ICP decreased after the treatment in both groups. Group B showed stable ICP (between 200 to 260 mmH_2O) after the treatment, except 1 patient who refused the implantation of stent in sinus had his ICP decreased from 620 to 410 mmH_2O; 1 patient had cerebral hemorrhage and was cured by operation. In group A, 1 patient had his ICP decreased to 350 mmH_2O and 5 had thier ICP reaching 400 mm H_2O; 1 died of cerebral hernia. The VAS scores in group A and group B were 8.1±1.6 and 3.5±1.5, respectively, 3 d after the treatment; the VAS scores in group A and group B were 4.9±1.4 and 2.2±1.3, respectively, 3 months after the treatment; significant differences were found between the 2 group (P<0.05). Conclusion Interventional thrombolysis is a safe and reliable method in treating patients with CVST through relieving the present symptoms and improving their prognosis.