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目的探讨重组组织血浆纤维蛋白溶酶原激活剂(rt-PA)局部溶栓治疗颅内静脉窦血栓形成的临床效果。方法自2002年10月至2010年1月,采用局部注射rt-PA溶栓治疗颅内静脉窦血栓形成21例,术后积极抗凝治疗6个月以上,定期随访。结果 21例共进行血管内注射药物24次,术后静脉窦显示完全再通17例,部分再通3例,无明显变化1例。术后随访10～24个月,平均18个月,未见静脉窦血栓复发。改良Rankin评分提示术后较术前明显好转。结论局部应用高选择性和安全性的rt-PA临床疗效较好,可有效避免不良反应的发生,为颅内静脉窦血栓形成的诊治开辟了新的途径。
Objective To investigate the clinical effect of recombinant thrombolytic plasminogen activator (rt-PA) on intracranial venous sinus thrombosis. Methods From October 2002 to January 2010, 21 cases of intracranial venous sinus thrombosis were treated with local injection of rt-PA thrombolytic therapy. After active anticoagulation therapy for more than 6 months, follow-up was performed regularly. Results Twenty-one patients underwent intravascular injection of drugs 24 times. There were 17 recanalization cases in the sinus and 3 cases recanalization in part, with no significant change in 1 case. The patients were followed up for 10-24 months with an average of 18 months. No recurrent sinus thrombosis was found. Improved Rankin score prompted significantly improved after surgery than before surgery. Conclusion Local application of rt-PA with high selectivity and safety has good clinical efficacy, which can effectively avoid the occurrence of adverse reactions and opens up new avenues for the diagnosis and treatment of intracranial venous sinus thrombosis.