论文部分内容阅读
目的探讨脑静脉窦血栓合并颅内出血的溶栓治疗的可能性及意义。方法脑血管造影明确诊断的脑静脉窦血栓合并脑出血患者6例,颈动脉穿刺行颈动脉内尿激酶注入3例,10万单位,1次/d,共7天,同时口服华法令。经股途径穿刺,静脉窦内置管溶栓3例,每日经微导管内给与尿激酶50万单位,2次/d。5~7天后复查DSA造影后拔管,同时口服华法令。结果术后6例临床症状不同程度缓解,头痛消失或明显减轻。脑脊液压力从400mmH2O降至200mmH2O以下。4例DSA复查结果提示,静脉窦较术前完全再通2例,部分再通2例,动静脉循环时间已缩短至11s内。结论采用颈动脉内注射或经静脉窦内置管直接溶栓,纤溶药物不仅可以直接起到溶解血栓和降低高凝血状态的作用,而且防止外周脏器的不必要的继发性出血。
Objective To explore the possibility and significance of thrombolytic therapy for cerebral venous sinus thrombosis complicated with intracranial hemorrhage. Methods Six patients with cerebral venous sinus thrombosis and intracerebral hemorrhage diagnosed by cerebral angiography were randomly divided into three groups. Carotid artery puncture was performed in 3 cases, 100000 units and 1 time per day for 7 days. At the same time, warfarin was given orally. Puncture through the stock market, venous sinus thrombolysis in 3 cases, daily administration of urokinase 50000 units by microcatheter, 2 times / d. After 5 to 7 days after DSA angiography extubation, while oral warfarin. Results After operation, the clinical symptoms of 6 patients were relieved to some extent, and the headache disappeared or obviously alleviated. Cerebrospinal fluid pressure decreased from 400 mmH2O to below 200 mmH2O. 4 cases of DSA review results suggest that the venous sinus recanalization than before surgery in 2 cases, 2 cases in part through, arteriovenous circulatory time has been reduced to 11s. Conclusion Intra-carotid artery injection or direct thrombolysis through the sinus tube can not only directly act as a thrombolytic agent and reduce the hypercoagulability, but also prevent unnecessary secondary hemorrhage of peripheral organs.