脑静脉系统血栓形成合并颅内出血的抗凝治疗16例.pdf

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1、NeuralIniurvAndFunctionalReconstruction，January2014，Vo1．9，No．1·论著·脑静脉系统血栓形成合并颅内出血的抗凝治疗16例刘艳，甘学军，关秀军，林丽晴，胡亚丹作者单位摘要目的：探讨脑静脉系统血栓形成(cVT)合并颅内出血后应用抗凝药物的疗效及风险。方法：连续收集武汉市第八医院神经CVT合并颅内出血的住院患者16例，确诊后给予低分子肝素抗凝治疗，通过每周1次头颅CT观察血肿内科体积动态变化，动态MRV观察血栓再通情况，并记录出血并发症的发生。结果：抗凝治疗前基线血肿体积武汉430010为(13．9+3．7)mL

2、，应用低分子肝素抗凝治疗1周后复查头颅CT测血肿体积为(10．1+2．7)mL，均无血肿扩大，8例明显吸收，2周复查头颅CT血肿体积(5．2+3．3)mL，血肿均吸收≥75％。无严重出血性并发症，收稿日期14dMRV复查15例血管再通。结论：抗凝治疗是CVT合并颅内出血的安全有效方法，尽早抗凝治疗可有2013．10．28效缓解症状，改善患者预后。通讯作者关键词脑静脉系统血栓形成；颅内出血；低分子肝素；疗效甘学军中图分类号R741；R741．05；R743．32文献标识码ADOI10．3870／ssc．2014．叭．007gwd647195@sina．comAnti

3、coagulantTherapyforCerebralVenousThrombosisAccompaniedbyIntracranialHemor·rhageL／UYan，GANXue-jun，GUANXiu-jun，LINLi-qing,HUya—dan．DepartmentofNeurology,the8thhospitalofWuhan，Wuhan43001~ChinaAbstractObjective：Toinvestigatetheefectandriskofanticoagulanttherapyforpatientswithcerebralvenou

4、sthrombosisaccompaniedbyintracranialhemorrhage．Methods：Sixteenpatientswithcerebralvenousthrombosisaccompaniedbyintracranialhemorrhagewerecollectedfromthein-patientdepartment．Theclinicalinformationwasrecordedindetail．Lowmolecularheparinwasgivenafterthedefinitediagnosiswasmade．CTscanwas

5、usedtoobservethedynamicchangeofhematomavolume．MRVwasusedtodeterminetherecanalization．Anybleedingcomplicationsweredocumented．Results：Thebaselinehematomavolumewasn3．9-+3．7)mL．Oneweekafteranticoagulanttherapy，thehematomavolumewasshrinkedtoto(1O．1+-2．7)mL．CTscandidnotshowexpansionofhemato

6、mavolumeandthehematomavolumewasobviouslyreducedin8patients(5O％)．Thehematomavolumewasreducedtof5．2+3．3)mLtwoweeksafteranticoagulanttherapy．Noseriousbleedingcom—plicationswereobserved．RecanalizationwasobservedbyMRVinl5patientstwoweeksafteranticoagulanttherapy．Conclusion：Anticoagulantthe

7、rapyisasafeandefectivetherapyforpatientswithcerebralvenousthrombosisaccompaniedbyintracranialhemorhage．EarlyanticoagulanttherapyCanimprovethesymptomsandprognosisofthesepatients．Keywordscerebralvenousthrombosis；intracranialhemorhage；lowmolecularheparin；therapeuticefect脑静脉系统血栓形成(cerebra

8、lveno