早期妊娠合并颅内静脉窦血栓的诊断与治疗(附4例报告)

摘要

目的 探讨早期妊娠合并颅内静脉窦血栓( CVST)的诊断与治疗. 方法 对4例早期妊娠合并CVST患者的临床资料进行回顾性分析. 结果 本组4例早期妊娠合并CVST患者的年龄为22~28岁.临床表现均为头痛,1例伴有癫痫发作. 查体可见视乳头水肿. 本组患者头颅MRI和MRV示上矢状窦血栓1例,上矢状窦和左侧横窦血栓1例,左侧横窦和乙状窦血栓2例. 本组患者均采用低分子肝素抗凝治疗,1例联合应用血管内介入溶栓治疗. 治疗后,2例治愈,2例好转. 结论 早期妊娠合并CVST易误诊,MRI和MRV检查有助于诊断,主要治疗方法为低分子肝素抗凝和血管内介入溶栓治疗.%Objective To investigate the diagnosis and treatment of cerebral venous sinus thrombosis ( CVST) in early pregnancy.Methods The clinical data of 4 patients with CVST in early pregnancy were analyzed retrospectively.Results The age of the 4 patients with CVST during early pregnancy was 22 -28 years old.The clinical symptom was headache, and 1 case with seizure.The clinical sign was papilledema.The MRI and MRV examination showed that the superior sagittal sinus thrombosis in 1 case, the superior sagittal sinus and left transverse sinus thrombosis in 1 case, and the left transverse sinus and sigmoid sinus thrombosis in 2 cases.The patients were received anticoagulant therapy with low molecular weight heparin, 1 case was added endovascular thrombolytic therapy.After therapy, 2 cases were cured, and 2 cases improved.Conclusions CVST in early pregnancy is easy to be misdiagnosed.MRI and MRV are helpful to diagnose it.The mainly therapies are endovascular thrombolysis and anticoagulation therapy with low molecular weight heparin.