硬脑膜静脉窦血栓形成的血管内介入治疗

目的 探讨硬脑膜静脉窦血栓形成(DVST)的血管内介入治疗。方法 11例由CT、MRI、DSA确诊的硬脑膜静脉窦血栓形成患者经皮股动、静脉穿刺给予介入治疗；围手术期规范抗凝、抗血小板聚集等综合治疗。结果 2例患者临床症状戏剧性改善，10例患者临床症状消失或好转，1例无变化；术后影像学均有不同程度的改善；1例机械辅助溶栓患者介入治疗时发生导丝断裂；1例机械辅助溶栓后置人支架未成功；术中、术后无其它相关并发症发生。出院时临床痊愈5例，显效3例，好转2例，无效1例。随访9例患者3～6月无复发。结论 多种介入方法联合治疗DVST的方法是可行的且安全有效。是值得在临床推广的治疗DVST的方法，其远期效果尚需观察。

Intervention therapy of dural venous sinus thrombosis

ObjectiveTo discuss the intervention therapy of dural venous sinus thrombosis(DVST ). Methods11 patients diagnosed DVST with MRA or/and DS A accepted combined treatment. Among them,5 cases dissolved thrombosis with uro kinase through artery or/and vein,7 cases dissolved thrombosis with assisted-mechanism and 4 cases were implanted stent after dissolved thrombosis. All patients were treated with anticoagulation and anti conglomeration of plaque surround operation. ResultsOne case encountered breakage of guiding wire during operation. One of ope rations of cerebral vein sinus stenting was failure. Clinic syndrome of 2 cases histrionically progressed durin g operation. All cases but one bettered or recovered before leaving hospital. ConclusionCombined therapy of dural venous sinus thrombo sis is feasible,safe and effective;most patient progress in not only DSA but a lso clinical syndrome. This method is valuable to spread in clinic application,but its long-term effect is not sure.