中华神经外科杂志
中華神經外科雜誌
중화신경외과잡지
Chinese Journal of Neurosurgery
2015年
5期
448-452
,共5页
李军%魏梁锋%许丙洋%张小军%王守森
李軍%魏樑鋒%許丙洋%張小軍%王守森
리군%위량봉%허병양%장소군%왕수삼
静脉窦血栓形成,颅内%颅脑损伤%危险因素%回顾性研究
靜脈竇血栓形成,顱內%顱腦損傷%危險因素%迴顧性研究
정맥두혈전형성,로내%로뇌손상%위험인소%회고성연구
Venous sinus thrombosis,cranial%Craniocerebral trauma%Risk factors%Retrospective studies
目的 分析外伤性颅内静脉窦闭塞(CVSO)的危险因素,探讨早期诊断外伤性CVSO的策略.方法 回顾性分析2011年8月至2013年5月南京军区福州总医院神经外科收治的240例创伤性中、重型闭合性颅脑损伤患者的临床资料,采用Logistic回归分析评估外伤性CVSO的危险因素.结果 240例创伤性颅脑损伤患者中,CVSO患者共40例,分为3型:血栓型静脉窦闭塞(Ⅰ型CVSO)、压迫型静脉窦闭塞(Ⅱ型CVSO)以及混合型静脉窦闭塞(Ⅲ型CVSO).跨静脉窦的颅骨骨折(OR=8.03;95％ CI:3.11 ～ 20.73)和跨静脉窦的硬膜外血肿(OR=3.06;95％ CI:1.36 ～6.92)是CVSO的危险因素,其中跨静脉窦的颅骨骨折与CVSO的相关性更为显著.女性(OR=10.31:95％CI:1.72～61.94)为Ⅰ型CVSO的危险因素;跨静脉窦的硬膜外血肿(OR =5.65;95％ CI:1.77～18.08)为Ⅱ型CVSO的危险因素;既往静脉血栓病史(OR=11.28;95％ CI:1.32～96.66)为Ⅲ型CVSO的危险因素.结论 在外伤性CVSO的早期诊断中,应关注跨静脉窦的骨折线和硬膜外血肿,重视静脉血栓病史的追查.此外,MR静脉造影/CT脑静脉造影有助于早期确诊CVSO.
目的 分析外傷性顱內靜脈竇閉塞(CVSO)的危險因素,探討早期診斷外傷性CVSO的策略.方法 迴顧性分析2011年8月至2013年5月南京軍區福州總醫院神經外科收治的240例創傷性中、重型閉閤性顱腦損傷患者的臨床資料,採用Logistic迴歸分析評估外傷性CVSO的危險因素.結果 240例創傷性顱腦損傷患者中,CVSO患者共40例,分為3型:血栓型靜脈竇閉塞(Ⅰ型CVSO)、壓迫型靜脈竇閉塞(Ⅱ型CVSO)以及混閤型靜脈竇閉塞(Ⅲ型CVSO).跨靜脈竇的顱骨骨摺(OR=8.03;95％ CI:3.11 ～ 20.73)和跨靜脈竇的硬膜外血腫(OR=3.06;95％ CI:1.36 ～6.92)是CVSO的危險因素,其中跨靜脈竇的顱骨骨摺與CVSO的相關性更為顯著.女性(OR=10.31:95％CI:1.72～61.94)為Ⅰ型CVSO的危險因素;跨靜脈竇的硬膜外血腫(OR =5.65;95％ CI:1.77～18.08)為Ⅱ型CVSO的危險因素;既往靜脈血栓病史(OR=11.28;95％ CI:1.32～96.66)為Ⅲ型CVSO的危險因素.結論 在外傷性CVSO的早期診斷中,應關註跨靜脈竇的骨摺線和硬膜外血腫,重視靜脈血栓病史的追查.此外,MR靜脈造影/CT腦靜脈造影有助于早期確診CVSO.
목적 분석외상성로내정맥두폐새(CVSO)적위험인소,탐토조기진단외상성CVSO적책략.방법 회고성분석2011년8월지2013년5월남경군구복주총의원신경외과수치적240례창상성중、중형폐합성로뇌손상환자적림상자료,채용Logistic회귀분석평고외상성CVSO적위험인소.결과 240례창상성로뇌손상환자중,CVSO환자공40례,분위3형:혈전형정맥두폐새(Ⅰ형CVSO)、압박형정맥두폐새(Ⅱ형CVSO)이급혼합형정맥두폐새(Ⅲ형CVSO).과정맥두적로골골절(OR=8.03;95％ CI:3.11 ～ 20.73)화과정맥두적경막외혈종(OR=3.06;95％ CI:1.36 ～6.92)시CVSO적위험인소,기중과정맥두적로골골절여CVSO적상관성경위현저.녀성(OR=10.31:95％CI:1.72～61.94)위Ⅰ형CVSO적위험인소;과정맥두적경막외혈종(OR =5.65;95％ CI:1.77～18.08)위Ⅱ형CVSO적위험인소;기왕정맥혈전병사(OR=11.28;95％ CI:1.32～96.66)위Ⅲ형CVSO적위험인소.결론 재외상성CVSO적조기진단중,응관주과정맥두적골절선화경막외혈종,중시정맥혈전병사적추사.차외,MR정맥조영/CT뇌정맥조영유조우조기학진CVSO.
Objectives To analyze the risk factors for traumatic cerebral venous sinus occlusion (CVSO) and to investigate the strategies of early diagnosis of traumatic CVSO.Methods The clinical data of 240 patients with moderate to severe closed traumatic brain injury admitted to the Department of Neurosurgery,Fuzhou General Hospital of Nanjing Military Command from August 2011 to May 2013 were analyzed retrospectively.Logistic regression analysis was used to evaluate the risk factors for traumatic CVSO.Results Of the 240 patients with traumatic brain injury,there were 40 patients with CVSO.They were divided into three types:CVSO of thrombotic type (CVSO type Ⅰ),CVSO of compression type (CVSO type Ⅱ),and CVSO of mixed type (CVSO type Ⅲ).Skull fracture (OR,8.03;95％ CI 3.11-20.73) and epidural hematoma (OR,3.06;95％ CI 1.36-6.92)of crossing venous sinus were the risk factors for CVSO,and the former was more significantly correlated with CVSO.Female gender (OR,10.31;95％ CI 1.72-61.94) was the risk factor for CVSO type Ⅰ;epidural hematoma of crossing venous sinus (OR,5.65;95％ CI 1.77-18.08) was the risk factor for CVSO type Ⅱ;and the previous history of vein thrombosis (OR,11.28;95％ CI 1.32-96.66) was the risk factors for CVSO type Ⅲ.Conclusions In the early diagnosis of traumatic CVSO,the crossing venous sinus fracture line and epidural hematoma should be given attention.Attention should be paid to tracing the history of venous thrombosis.In addition,MR venography and CT venography contribute to early diagnosis of CVSO.
