1例上矢状窦血栓患者动静脉溶栓的护理

报告了1例上矢状窦血栓形成患者进行动静脉溶栓的护理。护理要点包括术前加强患者和家属的心理护理,做好术前准备;术后密切观察患者有无出血倾向和药物不良反应,并有效预防并发症,做好健康教育和出院指导。     

抗磷脂综合征致矢状窦血栓1例护理体会

抗磷脂综合征 (APS)是指由抗磷脂抗体 (APL抗体 )引起的一组临床征象的总称。APL抗体是一组能与多种含有磷脂结构的抗原物质发生反应的抗体 ,包括狼疮抗凝物 (LA)、抗心磷脂抗体 (ACL抗体 )、抗磷脂酸抗体和抗磷脂酰丝氨酸抗体等。与APL抗体有关的临床表现主要为血栓形成、习惯     

3例上矢状窦血栓误诊为脑膜炎分析

上矢状窦血栓 (ＳＳＳ)是颅内静脉血栓的一种 ,是一种少见的脑血管病。由于该病临床表现复杂多样 ,从而导致本病诊断困难。本文报道 3例被误诊为脑膜炎的上矢状窦血栓。1　病例介绍【例 1】　患者女 ,35岁。产后 10日出现精神不振 ,头痛、嗜睡、恶心、呕吐。至当地医院就诊 ,当     

典型上矢状窦血栓1例报告

患者，女，20岁，于2001年4月28日产一健康女婴。于分娩后10天，出现发热、头痛、伴有恶心，喷射性呕吐。呕吐物为胃内容物，于第12天出现癫痫发作，以左侧上肢局限性发作，并逐渐发展为左侧半身，第15天出现左侧肢体活动无力，第17天出现意识障碍。在当地医院腰穿为血性脑脊液，在当地给予对症抗炎治疗，病情未见好转来我院。入     

乙状窦、上矢状窦血栓1例

患者女性，35岁。2个月前因恶心、呕吐、头痛来诊，无肢体活动障碍，无发热、抽搐，无尿失禁。就诊于乡镇医院应用低分子右旋糖酐500mL、复方丹参注射液30mL，症状未见好转，为进一步治疗来诊。既往有左中耳炎病史4年。查体：神志清，呼吸平稳，发育营养良好，双侧瞳孔等大，直径3mm，直、间接对光反射灵敏。双眼底视乳头边界不清，周围见点、片状渗出，四肢肌力V级，肌张力正常，巴彬斯基氏征（-）。辅助检查：血常规WBC6.7×109/L，RBC4.57×1012/L，PCT2.37×106/L。头颅MR右侧乙状窦、上矢状窦血栓形成。病例特点：（1）青年女性…     

产褥期上矢状窦血栓形成1例报告及文献回顾

产褥期并发上矢状窦血栓形成是脑血管疾病的一种特殊类型 ,十分少见 ,但病情凶险 ,病死率较高 ,如能早期诊断 ,合理治疗可提高疗效。我院治疗 1例 ,报道如下。1　病历简介女 ,36岁。孕 2产 2。因产后 7天出现右侧肢体无力进行性加重 ,于 2 0 0 1年 4月 1日入院。 7天前在本院妇产科剖腹娩出 1女婴。产后第 3天出现头痛 ,发热 ,体温 39℃ ,经静注头孢曲松钠后体温恢复正常 ,但出现表情淡漠 ,精神萎靡 ,未作特殊处理 ,于产后第 6天出院。入院查体 :T36 .8℃ ,P82次 / min,BP135 / 90 mm Hg(18/ 12 k Pa)。神经科检查 :神志朦胧 ,反应迟钝 ,…     

1例刀伤致上矢状窦及横窦损伤的院前急救护理

总结了1例因刀伤致上矢状窦及横窦损伤患者院前急救的护理体会,主要包括现场急救、转运过程中的护理、转运后的护理。认为快速、有效的院前急救对保存患者生命、降低死亡率和伤残率至关重要,为院内急救成功奠定了基础,是救治的关键。     

矢状窦血栓误诊为脑囊虫1例

患者,男,19岁。因头痛伴恶心、呕吐半个月,于2005年3月18日入院。患者1个月前上呼吸道感染,半个月前无明显诱因突发头痛,以前额部为主,呈持续性、阵发性加剧,伴恶心、呕吐,呕吐数次,偶呈喷射状,无发热。行头颅CT平扫及增强示:侧额顶叶见一小片高密度灶,直径0.6 cm。该灶增强前后CT值变化不明显,无明显的占位效应。怀疑脑囊虫。否认食豆猪肉史及便绦虫史,未见皮下结节。入院检查:一般情况尚可,意识清楚,眼底双侧视乳头边界不清,余颅神经未见异常,四肢肌力Ⅴ级,生理反射正常存在,病理反射未引出。实验室检查:血红蛋白130 g/L,白细胞9.8×109…     

一例上矢状窦静脉血栓形成患者介入术后的护理

上矢状窦静脉血栓形成是脑血管疾病的一种特殊类型,其病因复杂,发病形式多样,临床表现无特异性[1],临床主要表现为颅内压增高、癫痫发作和神经系统受损[2],近年来,通过股静脉置入鞘管,通过鞘管进行取栓及接触溶栓成为了本病的主要治疗方法之一。我科2011年8月收治1例上矢状窦血栓形成行介入治疗患者,现在将其介入术后护理体会汇报如下。1病例简介患者女性,48岁,临床表现为头晕,恶心,呕吐,站立不稳,     

脑静脉窦血栓形成致肌张力障碍康复1 例报道

目的探讨脑静脉窦血栓形成所致肌张力障碍的临床特点及康复方法。方法报道1 例脑静脉窦血栓形成患者,并结合文献分析。结果和结论经过抗凝治疗,神经功能缺损症状主要表现为左侧肢体活动不灵伴变形性肌张力障碍,经过康复训练、背肌局部治疗肉毒素后运动功能改善。     

Behcet's Disease: Presentation With Sagittal Sinus Thrombosis Diagnosed Noninvasively

The standard evaluation of patients with intracranial hypertension frequently does not reveal a discrete pathophysiologic process, leading in these cases to classification of the syndrome as "benign." We present a 35-year-old woman with a recent diagnosis of pseudotumor cerebri who presented with headache, emesis, and blurring of vision. Her symptoms were progressive despite two lumbar punctures that revealed normal cerebrospinal fluid under high pressure. Contrast and noncontrast CT scans were normal; both the cerebrospinal fluid and CT neuroimaging were thus consistent with benign intracranial hypertension. An MRI, however, supported the presence of sagittal sinus thrombosis, a finding which was confirmed by MR venography. Further workup for an underlying cause of sinus thrombosis disclosed symptoms and signs fulfilling the diagnostic criteria for Behcet's disease. Cerebral venous (or sinus) thrombosis should be considered in the differential diagnosis of intracranial hypertension. Behcet's disease, while extremely rare, should be considered as a potential cause of cerebral venous thrombosis. Magnetic resonance venography can serve as a useful diagnostic study in situations where confirmation or exclusion of sinus thrombosis is required.     

经腰椎截肢患者的综合康复护理1例

经腰椎截肢（包括全骨盆切除）,是目前平面最高的下肢截肢术。2007年3月18日本科收治一名经腰椎截肢患者,经过康复医生、护士、假肢工程师与技师、康复治疗师的共同努力,成功安装下肢假肢并实现行走,康复期间未出现严重并发症,最终成功回归社会。     

产后上矢状窦血栓形成12例报告及其预防措施的探讨

目的：探讨产后上矢状窦血栓形成的发病机制、诱发因素及预防发病的措施。方法：回顾12例产后上矢状窦血栓形成患者临床资料，特别是围产期并发症、合并症、分娩方式及产后生活起居等，分析诸因素与上矢状窦血栓形成的可能关系。结果：产褥期凝血机能增强，并发妊娠高血压综合征，产时、产后失血过多，产后多汗、不正确发汗，产后卧床较久、饮水不足、高脂饮食，产褥感染及剖宫产等是产后上矢状窦血栓形成的诱发因素。结论：注意围产期相关并发症、合并症的防治、严格剖宫产指征，避免盲目剖宫产及普及产褥期卫生知识，避免产后卧床较久、合理饮食，可减少产后上矢状窦血栓形成的发生。     

脑静脉窦血栓形成的诊断及治疗

目的:探讨脑静脉窦血栓形成(CVST)的临床特点。方法:对20例CVST患者的一般情况、病因、临床表现、脑脊液特点、影像学特征、治疗及预后等资料进行回顾性分析。结果:20例患者多表现为头痛,可伴有癫疒间发作和各种神经功能缺损的症状体征,脑脊液压力明显升高,白细胞数和蛋白质定量可正常或升高,头颅CT示静脉窦高密度改变及脑实质异常信号,MRI示静脉窦异常信号,MRV示静脉窦闭塞或充盈缺损,DSA示静脉窦狭窄、血流中断或不显影。治疗以脱水、抗凝、溶栓为主,19例好转,1例死亡。结论:对于高颅压伴或不伴神经、精神障碍的患者,须高度警惕CVST,应尽早行MRV或DSA检查,治疗以抗凝、溶栓为主。     

肾病综合征合并颅内静脉窦血栓致失明患儿一例的护理

目的总结1例肾病综合征合并颅内静脉窦血栓致失明患儿的护理方法。方法对肾病综合征合并颅内静脉窦血栓伴突发失明患儿进行溶栓、病情监测、心理治疗及综合护理。结果经积极治疗后血栓消失,光感恢复,尿蛋白转阴。结论精心细致的护理可使肾病综合征合并颅内静脉窦血栓致失明患儿临床治疗获得良好的效果。     

Cerebral Venous Sinus Thrombosis in the Emergency Department: Retrospective Analysis of 17 Cases and Review of the Literature

Background: Cerebral venous sinus thrombosis (CVST) is a rare but serious cause of neurologic impairment. Due to its relative rarity, there is limited research that describes the incidence and clinical features of CVST in the emergency department (ED). Objectives: To describe the demographic, clinical, and historical characteristics of patients with CVST who were initially seen in the ED. Methods: This is a retrospective analysis of all patients presenting to three urban, tertiary care hospitals between January 2001 and December 2005 who were diagnosed with CVST. Patients were excluded if they were transferred from other hospitals, or admitted directly to the hospital without evaluation in the ED. We use one representative case to describe the presentation, evaluation, and treatment of CVST. Results: Seventeen patients met the inclusion criteria. Patients had a mean age of 42 years. Presenting complaints included headache (70%), focal neurologic complaints (numbness, weakness, aphasia) (29%), seizure (24%), and head injury (12%). Ninety-four percent of patients had a focal neurologic finding in the ED. A likely contributing cause of thrombosis was identified in all but one patient. More than half of the patients had been evaluated in the ED in the previous 60 days. Two patients died, both as a result of their thrombosis and resulting cerebral infarctions and edema. Of the patients who survived, 80% had a good functional outcome. Conclusions: CVST is rare, but it can have significant associated morbidity and mortality. Whereas the clinical outcome and functional outcomes of treated patients can vary, prompt recognition of the disease is important.     

An Unusual Case of Cerebral Venous Sinus Thrombosis in a Pediatric Patient

Background: Cerebral venous sinus thrombosis (CVST) is a rare, but potentially devastating illness. It is important for emergency physicians to be aware of the classic and most common risk factors leading to this illness, including genetic and acquired prothrombotic states, infection, inflammatory conditions, and certain drugs. Objectives: The objectives of this article are to discuss a case of CVST and describe the signs and symptoms of CVST as well as the radiologic modalities used to diagnose this disease. Finally, we will discuss the causes and risk factors that lead to this potentially devastating diagnosis. Case Report: An 11-year-old girl was found unconscious and without pulses in an apparent drug overdose. Emergency Medical Services responders and Emergency Department personnel resuscitated the patient to a return of spontaneous circulation. The patient was intubated and admitted to the intensive care unit. As part of an altered mental status work-up, a magnetic resonance imaging scan of the head was performed and showed a cerebral venous sinus thrombosis. This was thought to be due to the drug overdose and the low-flow state that occurred during loss of circulation. After anticoagulation therapy and antibiotic treatment for sinusitis, the patient had a full recovery. Conclusion: Rapid diagnosis of CVST was essential to the appropriate care of this patient. Being aware of signs, symptoms, and risk factors leading to CVST will assist the emergency physician in making this diagnosis.     

脑静脉窦血栓形成的影像学检查及临床特征

目的:探讨脑静脉窦血栓形成(CVT)的临床特征及影像学特点,以寻求早期识别的征象及影像策略。方法:对62例经MR或/和DSA确诊为CVT的患者临床资料及影像学特点进行回顾性分析,并予抗凝治疗。结果:62例患者中有60例有非特异性头痛,其中56例行MRI+MRV检查确诊为CVT的有54例,32例经DSA检查均确诊为DVT。结论:CVT的临床表现缺乏特异性,MRI+MRV检查是诊断DVT的首选方法,DSA是诊断CVT的"金标准"。