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Endovascular regional thrombolysis treatment of severe dural venous sinus thrombosis
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- Author:
- No author available
- Journal Title:
- CHINESE JOURNAL OF RADIOLOGY
- Issue:
- 6
- DOI:
- 10.3760/j.issn:1005-1201.2003.06.015
- Key Word:
- 血栓溶解疗法;脑静脉;窦血栓形成;治疗结果
Abstract： 目的研究重症硬脑膜静脉窦血栓的局部溶栓治疗的方法及疗效.方法总结我院自2000年以来6例重症硬脑膜静脉窦血栓的局部溶栓治疗经验,男4例,女2例,其中4例采用一侧股动脉及对侧股静脉Seldinger穿刺,2例采用股动脉Seldinger穿刺及上矢状窦前1/3穿刺.导管置入一侧颈内动脉及静脉窦血栓处后,于颈内动脉及静脉窦血栓处先后各用尿激酶50万U,以每分钟1万U泵入,再于静脉窦血栓处泵入尿激酶持续溶栓,维持外周血中纤维蛋白原含量1.0～1.5 g/L,同时予全身肝素化,维持外周血活化部分凝血活酶时间正常值的2～3倍.结果本组6例,5例痊愈,颅内压转正常,头痛消失,无神经功能障碍,其中4例数字减影血管造影(DSA)见浅表静脉扩张消失,静脉窦显影正常,1例浅表静脉扩张明显改善,静脉窦显影较前好转;1例好转,颅内压较前降低,头痛好转,DSA见浅表静脉扩张消失,静脉窦显影正常,抗凝治疗1个月后颅内压正常,头痛消失,神经功能恢复正常.结论重症硬脑膜静脉窦血栓采用动静脉系统联合应用尿激酶局部溶栓治疗是快速、安全、有效的方法,经股静脉途径不易到达静脉窦血栓处者,可以行上矢状窦入路.
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