Clinical efficacy of improved thrombolytic regimen combined with systemic anticoagulation for cerebral venous sinus thrombosis
10.3760/cma.j.issn.1673-4904.2013.22.010
- VernacularTitle:改良溶栓方案联合全身抗凝治疗脑静脉窦血栓形成的临床研究
- Author:
Xiaoliang WANG
- Publication Type:Journal Article
- Keywords:
Thrombosis;
Anticoagulants;
Thrombolytic therapy
- From:
Chinese Journal of Postgraduates of Medicine
2013;36(22):29-31
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study the clinical efficacy and safety of improved thrombolytic regimen combined with systemic anticoagulation therapy for cerebral venous sinus thrombosis (CVST).Methods Fifty-seven patients with CVST were divided into anticoagulation group (34 cases) and combined thrombolysis group (23 cases) according to different treatment.On the basis of conventional therapy,patients in anticoagulation group were given low molecular weight heparin anticoagulant therapy; while patients in combined thrombolysis group were given improved thrombolytic interventional treatment program.Neurological deficit scores,the degree of disabihty,the recanalization rate and adverse reaction rate after treatment of two groups were compared.Results Cases in combined thrombolysis group received thrombolytic therapy for 2-8 d,and urokinase total application was 26 million-384 million U.Nerve function in combined thrombolysis group improved significantly compared with that in anticoagulatian group after treatment (Z =-1.725,P =0.048).The degree of disability after treatment was assessed by menopause rating scale (mRS) scores.The number of fully restored,partially restored,disability and death in anticoagulation group was 19,6,6 and 3 cases,respectively,while in combined thrombolysis group was 20,2,1 and 0 case.The degree of disability in combined thrombolysis group after treatment was significantly lower than that in anticoagulation group (Z =-1.894,P =0.043).Sixteen patients in combined thrombolysis group underwent angiography after treament,among whom complete recanalization occurred in 7 cases,and partial recanalization in 9 cases.Magnetic resonance imaging on veins review was done in 19 cases in anticoagulation group,among whom complete recanalization occurred in 3 cases,partial recanalization in 15 patients,and no significant change in 1 case.Thrombus recanalization rate in combined thrombolysis group was significantly higher than that in anticoagulantion group (Z=-2.126,P=0.024).Incidence of adverse reactions was higher than that in anticoagulation group [30.4％(7/23) vs.5.9％(2/34)](x2 =17.432,P＜0.01).The incidence of intracranial hemorrhage of the two groups had no significant difference (Z =-0.766,P =0.157).Conclusion The improved thrombolytic therapy program is more suitable for patients of a relatively short duration,especially with acute onset of CVST,which can effectively improve neurological function in patients and improve clinical outcomes.
