颅内静脉窦血栓形成的抗凝治疗疗效

摘要

Objective:To explore the therapeutic effects of different anticoagulant therapies on intracranial venous si-nus thrombosis.Methods:A total of 150 patients with intracranial venous sinus thrombosis in our hospital from Jan 2011 to Jun 2013 were selected.According to random number method,they were divided into low molecular weight heparin (LMWH)group (n=50),unfractionated heparin group (UFH group,n=50)and interventional thrombol-ysis group (n=50,received interventional thrombolysis,patients received LMWH anticoagulant therapy after their conditions were stable).Therapeutic effects and incidences of complications were observed and compared among three groups.Results:After three-month treatment,total effective rate of interventional thrombolysis group was significantly higher than those of LMWH group and UFH group (98% vs.82.0% vs.72.0%),P <0.05 or <0.01;compared with LMWH group and UFH group,there were significant reductions in Rankin scale (mRS)score [(1.3 ±0.3)scores,(1.6±0.4)scores vs.(1.0±0.2)scores]and incidence rate of adverse reactions (16.0%,18.0%vs.4.0%)in interventional thrombolysis group (P <0.05 or <0.01),and there were no significant difference be-tween LMWH group and UFH group (P >0.05).Conclusion:Anticoagulant therapeutic effect of LMWH is better than that of UFH,but pure anticoagulant therapy cannot relieve patient′s condition completely.Interventional thrombolysis combined anticoagulant therapy possess good therapeutic effect,which is worthy of extension in clinic.%目的：探讨不同的抗凝治疗方法对颅内静脉窦血栓形成的临床疗效。方法：选择从2011年1月到2013年6月期间我院收治的颅内静脉窦血栓形成进行抗凝治疗的患者150例，按照随机数字法分为低分子肝素组（50例），普通肝素组（50例）和介入溶栓组（50例，采取介入溶栓治疗，病情稳定后采用低分子肝素进行抗凝治疗），观察三组患者的临床疗效及其并发症的发生情况。结果：治疗3个月后，介入溶栓组患者总有效率显著高于低分子肝素组和普通肝素组（98.0％比82.0％比72.0％），P ＜0.05或＜0.01；与低分子肝素组和普通肝素组比较，介入溶栓组的改良 Rankin 量表（mRS）评分[（1.3±0.3）分、（1.6±0.4）分比（1.0±0.2）分]和不良反应发生率（16.0％、18.0％比4.0％）显著降低（P ＜0.05或 ＜0.01），低分子肝素组与普通肝素组间无显著差异（P ＞0.05）。结论：低分子肝素的抗凝治疗效果优于普通肝素，但是单纯的抗凝治疗并不能使病情完全缓解，介入溶栓联合抗凝治疗的疗效较好，值得临床推广。