156例颅内静脉窦血栓形成患者的临床及影像学特征分析
发布时间：2019-06-21 13:25
【摘要】：目的分析比较156例确诊为颅内静脉窦血栓形成患者的临床及影像学特征。收集所有入组患者的临床及影像学资料,并对继发脑实质损伤患者可能存在的相关因素(如性别,年龄,平均住院时间,起病急缓,已知病因,临床表现差异,实验室检查结果,血栓累及静脉窦部位、数目和短期预后等情况)进行统计学分析比较。为提高静脉窦血栓形成患者的临床诊疗水平。方法回顾性分析所有入组的156例患者的临床资料,并根据颅脑CT或MRI影像学检查结果,分为脑实质病灶阳性组(82例)和阴性组(74例),比较分析两组患者的一般情况、病因、临床表现、影像学检查、受累静脉窦及短期预后的差异。结果两组患者单因素比较,颅内静脉系统血栓形成的病因主要为感染、妊娠、血液系统疾病及代谢、自身免疫性疾病等,阳性组血液系统疾病(包括贫血、血小板增多或减少、白血病、MDS等)患者居多,阴性组患者继发于局部感染及术后脱水患者居多;在临床表现方面,阳性组发生癫痫、意识障碍、精神症状、神经功能缺损(包括单侧运动障碍、中枢性面舌瘫、言语功能障碍)、查体示病理征阳性的比率均高于阴性组,均有显著性差异(P0.05);据统计,阳性组血栓形成发生于上矢状窦的比率低于阴性组(?2=4.480,P=0.034);DSA检查可发现MRV不能明确的病因,如动静脉畸形、先天性静脉及静脉窦发育不良等;出院时阳性组症状完全恢复(改良Rankin评分0~2分)的比率低于阴性组(?2=19.765,P=0.000);二元多因素Logistic回归分析示阳性组患者意识障碍更重,累及上矢状窦者更少,短期预后更差。结论1、颅内静脉系统血栓形成的病因主要为感染、妊娠、血液系统疾病及代谢、自身免疫性疾病等;且合并血液系统疾病患者更容易累及脑实质损伤。2、DSA检查可发现MRV检查不能明确的脑血管畸形及静脉窦先天发育不良等潜在病因,对此病的病因学诊断意义重大,还可以了解管腔闭塞程度及侧支循环建立情况,建议临床有条件者应尽量积极行DSA检查。
[Abstract]:Objective to analyze and compare the clinical and imaging features of 156 patients with intracranial venous sinus thrombosis. The clinical and imaging data of all the patients were collected, and the possible related factors (such as sex, age, average hospitalization time, onset of onset, known etiology, clinical manifestation differences, laboratory examination results, thrombus involved in venous sinus, number and short-term prognosis) were statistically analyzed and compared among the patients with secondary brain parenchyma injury (such as sex, age, average hospitalization time, onset of onset, known etiology, clinical manifestation difference, laboratory examination results, thrombus involved in venous sinus, number and short-term prognosis, etc.). In order to improve the clinical diagnosis and treatment of patients with venous sinus thrombosis. Methods the clinical data of all patients were analyzed retrospectively. according to the results of CT or MRI imaging examination, they were divided into positive group (82 cases) and negative group (74 cases). The general situation, etiology, clinical manifestations, imaging examination, involved venous sinus and short-term prognosis of the two groups were compared and analyzed. Results the main causes of intracranial venous thrombosis were infection, pregnancy, blood system disease and metabolism, autoimmune diseases and so on. Most of the patients in the positive group had blood system diseases (including anemia, platelet increase or decrease, leukemia, MDS, etc.), and most of the patients in the negative group were secondary to local infection and postoperative dehydration. In terms of clinical manifestations, seizures, disturbance of consciousness, mental symptoms and neurological defects (including unilateral motor disorder, central facial tongue paralysis, speech dysfunction) in the positive group were significantly higher than those in the negative group (P < 0.05). According to statistics, the incidence of thrombosis in the superior sagittal sinus in the positive group was lower than that in the negative group (? 2: 4.480, P 鈮，
本文编号：2504112
[Abstract]:Objective to analyze and compare the clinical and imaging features of 156 patients with intracranial venous sinus thrombosis. The clinical and imaging data of all the patients were collected, and the possible related factors (such as sex, age, average hospitalization time, onset of onset, known etiology, clinical manifestation differences, laboratory examination results, thrombus involved in venous sinus, number and short-term prognosis) were statistically analyzed and compared among the patients with secondary brain parenchyma injury (such as sex, age, average hospitalization time, onset of onset, known etiology, clinical manifestation difference, laboratory examination results, thrombus involved in venous sinus, number and short-term prognosis, etc.). In order to improve the clinical diagnosis and treatment of patients with venous sinus thrombosis. Methods the clinical data of all patients were analyzed retrospectively. according to the results of CT or MRI imaging examination, they were divided into positive group (82 cases) and negative group (74 cases). The general situation, etiology, clinical manifestations, imaging examination, involved venous sinus and short-term prognosis of the two groups were compared and analyzed. Results the main causes of intracranial venous thrombosis were infection, pregnancy, blood system disease and metabolism, autoimmune diseases and so on. Most of the patients in the positive group had blood system diseases (including anemia, platelet increase or decrease, leukemia, MDS, etc.), and most of the patients in the negative group were secondary to local infection and postoperative dehydration. In terms of clinical manifestations, seizures, disturbance of consciousness, mental symptoms and neurological defects (including unilateral motor disorder, central facial tongue paralysis, speech dysfunction) in the positive group were significantly higher than those in the negative group (P < 0.05). According to statistics, the incidence of thrombosis in the superior sagittal sinus in the positive group was lower than that in the negative group (? 2: 4.480, P 鈮，
本文编号：2504112
本文链接：https://www.wllwen.com/yixuelunwen/shenjingyixue/2504112.html
最近更新
教材专著
