妊娠和产褥期上矢状窦血栓形成的发病时间与临床特征的分析研究

发布时间：2018-02-16 22:32

本文关键词： 妊娠产褥期脑卒中上矢状窦栓塞　出处：《中南大学》2014年硕士论文　论文类型：学位论文

【摘要】：目的：回顾性分析2002-2013年国内243例妊娠和产褥期上矢状窦血栓形成患者的发病时间、临床特征和影像学检查的资料,为早期诊断妊娠和产褥期上矢状窦血栓形成提供依据。资料与方法：利用相关期刊论文,检索2002-2013年国内报道及我院收集的共243例妊娠和产褥期上矢状窦血栓形成患者的临床资料,按产前、产时及产后三个发病阶段,分析研究妊娠和产褥期上矢状窦血栓形成患者的临床特征、诊断、影像学的改变与预后。结果：243例妊娠和产褥期上矢状窦血栓形成患者中,产前及产时发病患者均以急性发病,误诊率及死亡率分别高达70%、60%,分别占总病例数的2.9%和1.2%；且颅压增高的发生率均为100%,抽搐的发生率为85.7%和100%,意识改变的发生率为71.4%和66.7%,肌力下降或肢体瘫痪的发生率为57.1%和33.3%。产后发病者以亚急性或急性起病,误诊率及死亡率分别为2.6%和7.3%,病例数占95.9%。上述4种临床特征发生率的比例依次为87.6%、53.6%、43.8%和45.9%。CT检查和MRI/MRV检查的阳性率分别为33.3%和100%。结论：产褥早期是妊娠和产褥期上矢状窦血栓形成患者高发时期。产前及产时发病的患者病情发展快,误诊率及死亡率高。对产前疑似的患者应尽早进行MRI/MRV确诊并给以及时有效的治疗。
[Abstract]:Objective: to analyze retrospectively 243 cases of superior sagittal sinus thrombosis during pregnancy and puerperium in China from 2002 to 2013, and to provide evidence for early diagnosis of superior sagittal sinus thrombosis in pregnancy and puerperium. Materials and methods: a total of 243 cases of upper sagittal sinus thrombosis in pregnancy and puerperium were collected from 2002 to 2013 by using the full text database of Chinese periodicals. To study the clinical features, diagnosis, imaging changes and prognosis of patients with superior sagittal sinus thrombosis during pregnancy and puerperium. Results among 243 cases of upper sagittal sinus thrombosis during pregnancy and puerperium, acute onset was found in prenatal and parturient patients. The misdiagnosis rate and mortality rate were as high as 70% and 60%, accounting for 2.9% and 1.2% of the total cases, respectively, and the incidence of intracranial hypertension was 100, the incidence of convulsions was 85.7% and 100, the incidence of consciousness change was 71.4% and 66.7, and the incidence of myoplegia or limb paralysis was 71.4% and 66.7 respectively. 57.1% and 33. 3. The postpartum onset was subacute or acute. The misdiagnosis rate and mortality rate were 2.6% and 7.3, respectively. The incidence rates of the four clinical characteristics were 87.6% and 43.8%, respectively, and the positive rates of CT and MRI/MRV were 33.3% and 100, respectively. Conclusion: the early puerperal period is the period of high incidence of superior sagittal sinus thrombosis in pregnancy and puerperium. The misdiagnosis rate and mortality rate are high. MRI/MRV diagnosis and prompt and effective treatment should be carried out as soon as possible for suspected prenatal patients.
【学位授予单位】：中南大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R743.3

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