妊娠不同阶段并发颅内静脉血栓形成的临床特征

摘要

目的:探讨妊娠不同阶段与颅内静脉血栓形成(CVT)的发病机制、临床特征.方法:收集妊娠及产后并发静脉窦血栓形成患者34例的临床资料,分析妊娠并发CVT的临床特征,复习相关文献.结果:本组34例患者中,妊娠期20例,产褥期14例,平均发病年龄为(26.4±4.1)岁.通常急性起病,数天内达高峰,头痛、癫痫发作、意识障碍为最常见的临床症状.妊娠剧吐、产褥感染、妊高症、剖宫产术并发症、贫血以及低蛋白血症均为妊娠并发CVT的危险因素.D-D二聚体异常及颅内静脉血管造影检查为诊断的金标准.及早诊断、尽早抗凝是治疗的关键.结论:妊娠不同时期均可发生CVT.%Objective:To investigate the pathogenesis and clinical features of cerebral venous thrombosis (CVT) during different periods of pregnancy.Methods:Clinical data of 34 pregnant and postpartum patients diagnosed as CVT were collected.The related literature to summary risk factors,treatment and prevention measures of CVT in different periods were reviewed.Results:There are 34 cases with CVT,including 20 pregnant and 14 postpartum women.Average age of onset was (26.4±4.1) years old.Headaches,seizures,disturbances of consciousness were the most common clinical symptoms with acute onset.Hyperemesis gravidarum,puerperal infections,pregnancy-induced hypertension,caesarean birth complications,anemia and hypo-albuminemia were the risk factors for pregnancy complicated with CVT.D-dimer in combination with venous angiography was the golden diagnostic standard.Earlier diagnosis and anticoagulation therapy were the key treatment.Conclusion:CVT could occur during all periods of pregnancy.