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硬膜窦血栓罕见,且病因很多。临床表现多样,从短暂的轻微症状直至死亡。早期诊断及治疗对神经功能障碍恶化的患者尤为重要。5例上矢状窦或横窦血栓的病人经尿激酶窦内直接溶栓,神经功能均恢复良好。另有3例患者未行直接溶栓,皆因大片脑梗塞及出血而死亡。溶栓技术:经皮穿刺股静脉,5F导引管经股静脉、下腔静脉、右心房、颈内静脉直至颈静脉球。肝素全身抗凝。Tracker-18导管连同导丝经导引管插入乙状窦、横窦、窦汇直至上矢状窦。2秒钟内手推4ml Ominipaque300,行数字减影造影。溶栓方法:连续5分钟直接向静脉窦血栓冲击注射8万U尿激酶;15分钟后
Dural sinus thrombosis rare, and a lot of causes. Clinical manifestations vary from short, mild symptoms to death. Early diagnosis and treatment of patients with neurological dysfunction is particularly important. Five cases of superior sagittal sinus or transverse sinus thrombosis were directly thrombolytic thrombolysis of urokinase, nerve function were recovered well. Another three patients did not directly thrombolysis, are due to large cerebral infarction and bleeding and death. Thrombolysis: percutaneous femoral vein, 5F guide tube through the femoral vein, inferior vena cava, right atrium, internal jugular vein until the jugular bulb. Heparin systemic anticoagulation. Tracker-18 catheter with guide wire through the catheter into the sigmoid sinus, transverse sinus, sinus sink until the superior sagittal sinus. Hand pushing 4ml Ominipaque300 within 2 seconds, digital subtraction angiography. Thrombolytic method: continuous injection of 80000 urokinase into sinus venous thrombus for 5 minutes; after 15 minutes