静脉侧支回流在多发性脑静脉窦血栓病中的作用(附89例分析)

目的 探讨静脉侧支回流在多发性脑静脉窦血栓病程中的作用。方法对我科收治的89例多发性脑静脉窦血栓病人采用经颈动脉溶栓、静脉窦内留置微导管连续溶栓等治疗方法，同时辅以全身抗凝治疗，观察临床效果和侧支循环的变化。结果所有病例治疗后颅内压均明显下降，DSA示残留静脉窦有回流63例，海绵窦代偿性引流75例，椎静脉丛引流35例，头皮静脉代偿引流14例。结论血管内溶栓和抗凝是治疗脑静脉血栓较为可靠和安全的方法：静脉侧支回流的建立和加强对于多发性脑静脉窦血栓的治疗和预后判断意义重大。

Role of collateral venous circulation in the course of multiple cerebral venous sinus thrombosis: analysis of 89 cases

Objective To investigate the role of collateral venous circulation in the course of multiple cerebral venous sinus thrombosis. Methods Eighty-nine patients with cerebral venous thrombosis in our department were treated by thrombolysis via carotid or indwelling micro-catheter in sinus via jugular approach, in the same time, general anticoagulation was given as a adjuvant therapy. Results Intracranial pressure of all the patients reduced obviously, there were four draining ways to be founded or strengthened at least during the course, including residual sinus return in 63 cases, cavernous sinus compensation in 75, vertebral venous plexus in 35, and scalp venous drainage in 14. Conclusion Combination of endovascular thrombolytic treatments and general anticoagulation is a safe and reliable method for cerebral venous thrombosis. Establishment and strengthen of collateral venous circulation are in favor of improvement and prognosis of the thrombosis.