摘要
目的探讨急性重症颅内静脉窦血栓经Solitaire AB支架取栓联合局部溶栓治疗的方法及疗效。方法回顾性分析2013年1月—2018年1月收治17例急性重症颅内静脉窦血栓形成患者的资料,其中8例为对照组,行单独抗凝治疗,9例为介入治疗组,给予抗凝、Solitaire AB支架取栓及静脉窦内置管接触性溶栓治疗,随访12个月观察并对比两组病例的栓塞血管主干再通情况、Glasgow昏迷量表评分、改良Rankin量表评分以及不良反应发生率。结果介入治疗组患者栓塞血管主干再通率(77.78%)以及治疗后不良反应发生率(50.00%)与单纯抗凝治疗组(12.50%)、(37.50%)结果比较均显著较优,差异有统计学意义(χ^2=8.657 4、5.698 3,P<0.05);介入治疗组患者出院后Glasgow昏迷量表评分5分例数(8例)显著高于对照组(4例),4分例数为1例显著低于对照组(4例),差异有统计学意义(t=8.635 4、6.324 7,P<0.05);介入治疗组患者改良Rankin量表评分≤1分例数为7例(77.78%),显著多于单纯抗凝治疗组3例(37.50%),差异有统计学意义(t=9.635 1,P<0.05)。结论采用多渠道包括抗凝、Solitaire AB支架取栓、接触性溶栓等方式治疗急性重症颅内静脉窦血栓形成能尽快开通栓塞的静脉窦,值得推广。
Objective To investigate the method and effect of acute severe intracranial sinus thrombosis treated with Solitaire AB stent thrombectomy combined with local thrombolysis. Methods A retrospective analysis of 17 patients with acute severe intracranial venous sinus thrombosis was performed from January 2013 to January 2018. Eight of them were in the control group, with anticoagulant therapy alone and 9 patients in the interventional group, anticoagulation, Solitaire AB stent thrombectomy and venous sinus catheter contact thrombolysis, follow-up 12 months of followup and comparison of embolization vascular trunk recanalization, Glasgow coma scale score, modified Rankin scale score and rate of poor reaction. Results The recanalization rate of embolized vascular trunk (77.78%) and the incidence of adverse reactions after treatment (50.00%) were significantly better than those of the anticoagulant therapy group (12.50%) and (37.50%)(χ^2 =8.657 4, 5.698 3, P<0.05);the Glasgow Coma Scale score of 5 patients after discharge (8 cases) was significantly higher than that of the control group (4 cases), and the number of 4 points (1 case) was significantly lower than that of the control group (4 cases)(t=8.635 4, 6.324 7, P<0.05);in the intervention group, the modified Rankin scale score ≤ 1 score was 7 cases (77.78%), significantly more than the simple anticoagulant treatment group (3 cases) 37.50%(t=9.635 1, P<0.05), the difference was statistically significant. Conclusion Multi-channel including anticoagulation, Solitaire AB stent thrombectomy, contact thrombolysis and other methods for the treatment of acute severe intracranial venous sinus thrombosis can open the embolized sinus as soon as possible, it is worth promoting.
作者
冉忠营
RAN Zhong-ying(Guizhou Provincial People's Hospital, Guiyang, Guizhou Province, 550002 China)
出处
《系统医学》
2019年第16期60-62,共3页
Systems Medicine
