CAJ | 학술논문

目的系统评价颅内静脉窦血栓形成(CVST)合并颅内血肿(ICH)的各种治疗方式的疗效,为临床治疗方案的制定提供参考依据. 方法使用关键词cerebral venous sinus thrombosis 、intracranial hematoma及相关词汇、同义词汇等,检索Pubmed、ISI Web of science、Cochrane library databases数据库,并手工检索相关期刊,其中设置发表时间截止至2015年1月,语言为英语,不受发表类型、发表领域等限制,从而筛选文献、提取数据进行系统评价. 结果最终纳入17篇文献,共收集31例患者.其中在临床表现Ⅰ级的6例患者中,行抗凝治疗3例,行手术治疗、血管内介入治疗及使用2种术式以上各一例,改良Rankin量表(mRS)评分均为0分;在临床表现Ⅱ级的11例患者中,行抗凝治疗2例的mRS评分分别为0分、6分,行手术治疗3例的mRS评分分别为0分、1分、6分,行血管内治疗1例的mRS评分为0分,使用2种及以上术式5例的mRS评分分别为0分1例及1分、2分各2例;在临床表现Ⅲ级的8例患者中,行抗凝治疗1例的mRS评分为2分,行手术治疗3例的mRS评分分别为1分、2分、4分,行血管内介入治疗4例的1例mRS评分为0分,3例为1分. 结论对于CVST合并ICH患者,行单纯抗凝治疗或单纯手术治疗并不能够完全控制其中临床表现较重患者的病情,而联合术式治疗可能是比较合适的治疗方案.
목적 계통평개로내정맥두혈전형성(CVST)합병로내혈종(ICH)적각충치료방식적료효,위림상치료방안적제정제공삼고의거. 방법 사용관건사cerebral venous sinus thrombosis 、intracranial hematoma급상관사회、동의사회등,검색Pubmed、ISI Web of science、Cochrane library databases수거고,병수공검색상관기간,기중설치발표시간절지지2015년1월,어언위영어,불수발표류형、발표영역등한제,종이사선문헌、제취수거진행계통평개. 결과 최종납입17편문헌,공수집31례환자.기중재림상표현Ⅰ급적6례환자중,행항응치료3례,행수술치료、혈관내개입치료급사용2충술식이상각일례,개량Rankin량표(mRS)평분균위0분;재림상표현Ⅱ급적11례환자중,행항응치료2례적mRS평분분별위0분、6분,행수술치료3례적mRS평분분별위0분、1분、6분,행혈관내치료1례적mRS평분위0분,사용2충급이상술식5례적mRS평분분별위0분1례급1분、2분각2례;재림상표현Ⅲ급적8례환자중,행항응치료1례적mRS평분위2분,행수술치료3례적mRS평분분별위1분、2분、4분,행혈관내개입치료4례적1례mRS평분위0분,3례위1분. 결론 대우CVST합병ICH환자,행단순항응치료혹단순수술치료병불능구완전공제기중림상표현교중환자적병정,이연합술식치료가능시비교합괄적치료방안.
Objective To systemically evaluate the efficacy of all kinds of therapies of cerebral venous sinus thrombosis (CVST) associated with intracranial hematoma (ICH) and provide reference for making treatment scheme.Methods We searched English databases (Pubmed,ISI Web of science and Cochrane library databases) for publications on CVST associated with ICH and the relevant references of those articles.Retrieval time deadline was up to January 2015,and the language was set to English.All publications were searched without restrictions of publication type or published fields.Documents were screened to extract data and to analyze systemically.Results In total,17 articles fulfilled the inclusion criteria and included 31 patients.Because of the severities of reported cases were greatly different and treatments were varied,these patients were divided into 3 levels to get a better understanding of the efficacy.In 6 patients of stage Ⅰ,3 accepted anticoagulation,1 operative treatment,1 endovascular intervention and the left one used more than one methods;the prognosis was good and modified Rankin scale (mRS) score was 0 no matter which kind of therapy was performed.In 11 patients of stage Ⅱ,2 accepted anticoagulation enjoyed mRS scores of 0 and 6,3 operative treatment enjoyed mRS scores of 0,1 and 6,1 endovascular intervention enjoyed mRS scores of 0,and the left 5 used more than one method enjoyed mRS scores of 0,1,1,2 and 2.In 8 patients of stage Ⅲ,1 accepted anticoagulation enjoyed mRS scores of 2,3 operative treatment enjoyed mRS scores of 1,2 and 4,and 4 endovascular intervention enjoyed mRS scores of 0,1,1 and 1.Conclusion It seems that anticoagulation therapy alone may not be effectively enough for those patients that with severe clinical or imaging features;individualized therapy strategies with different types would be more effective.