CAJ | 학술논문

目的：探讨孕产妇合并颅内静脉窦血栓形成（ CVST ）的临床和影像学特点、诊治及预防。方法回顾性分析32例孕产期颅内静脉窦血栓形成患者病历资料。结果32例患者分布为早期妊娠4例、中晚期妊娠5例、产褥期23例，剖宫产、感染因素和重度子痫前期是主要发病诱因；首发症状27例（84．4％）；早期头颅C T 13例，5例未检出病变，29例头颅M RI＋M RV检查确诊。确诊后给予积极治疗诱因和低分子肝素抗凝等治疗，11例病人介入微导管尿激酶局部灌注，死亡4例（12．5％），3例（9．4％）遗留轻偏瘫。结论孕产期颅内静脉窦血栓形成以产褥期多发，早期临床症状无特异性，以慢性颅内压增高症状为主。头颅M RI＋M RV 诊断符合率高，及早控制危险因素及抗凝、介入溶栓有较好的疗效。
목적：탐토잉산부합병로내정맥두혈전형성（ CVST ）적림상화영상학특점、진치급예방。방법회고성분석32례잉산기로내정맥두혈전형성환자병력자료。결과32례환자분포위조기임신4례、중만기임신5례、산욕기23례，부궁산、감염인소화중도자간전기시주요발병유인；수발증상27례（84．4％）；조기두로C T 13례，5례미검출병변，29례두로M RI＋M RV검사학진。학진후급여적겁치료유인화저분자간소항응등치료，11례병인개입미도관뇨격매국부관주，사망4례（12．5％），3례（9．4％）유류경편탄。결론잉산기로내정맥두혈전형성이산욕기다발，조기림상증상무특이성，이만성로내압증고증상위주。두로M RI＋M RV 진단부합솔고，급조공제위험인소급항응、개입용전유교호적료효。
Objective To study the clinical and imaging features ,the diagnosis ,treatment and prevention of cerebral venous sinus thrombosis (CVST ) during pregnancy and puerperium .Methods A retrospective study was performed in 32 cases of pregnant women with CVST .Results There were 4 cases of early preg-nancy ,5 cases of midtremester and late pregnancy and 23 cases of puerperium .The primary inducements MRV .The treatment included removing induced factors and low molecular heparin anticoagulation in all confirmed CVST cases .11 cases were treated with local infusion of urokinase by interventional catheter ,3 cases (9 .4% ) remained in hemiparesis and 4 cases (12 .5% ) died .Conclusion Maternal CVST is common in puerperium ,and no early clinical specificity can be found .The main initial symptom is intracranial hy-pertension .M RI and M RV can produce high accordance rate .Early control of risk factors ,anticoagulant therapy and interventional thrombolytic therapy are effective in treating CVST.