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目的探讨妊娠合并颅内静脉血栓形成的危险因素、临床特点和母婴结局。方法回顾分析我院2005年1月至2010年1月发生的12例妊娠合并颅内静脉血栓形成患者临床表现及结局。结果 (1)有12例颅内静脉血栓形成,发生比例为0.17‰。重度子痫前期/子痫共1775例。发生颅内静脉血栓形成10例,发生比例为5.63‰。(2)临床特点:发病时间多发于术后24h内。首发症状多为头痛、呕吐、视物不清等颅内压增高表现。依据血栓形成部位不同可引起神经局灶性体征。如抽搐,肌无力,偏瘫,四肢瘫,视力障碍和病理反射征阳性。所有患者CT均为上矢状窦静脉血栓形成。结论妊娠合并颅内静脉血栓形成好发于重度子痫前期/子痫患者,多发生于术后24h内。表现为产科用药难以控制的抽搐应立即行神经影像学检查:如CT,MRI等尽早诊断,尽早治疗。血清D-二聚体、纤维蛋白原、HDL-C检测可能有一定的预测意义。
Objective To investigate the risk factors, clinical features and maternal-infant outcome in patients with intracranial venous thrombosis during pregnancy. Methods A retrospective analysis of our hospital from January 2005 to January 2010 occurred in 12 cases of pregnancy with intracranial venous thrombosis in patients with clinical manifestations and outcomes. Results (1) There were 12 cases of intracranial venous thrombosis, the incidence was 0.17 ‰. A total of 1775 cases of severe preeclampsia / eclampsia. Occurrence of intracranial venous thrombosis in 10 cases, the incidence was 5.63 ‰. (2) clinical features: onset time occurred in 24h after surgery. The first symptom is mostly headache, vomiting, blurred vision and other increased intracranial pressure performance. Depending on the site of thrombosis can cause focal neurological signs. Such as convulsions, muscle weakness, hemiplegia, quadriplegia, visual impairment and pathological reflex sign positive. All patients had superior sagittal sinus venous thrombosis. Conclusion Pregnancy complicated with intracranial venous thrombosis occurs in patients with severe preeclampsia / eclampsia and occurs mostly within 24 hours after operation. The performance of obstetrical medication difficult to control the convulsions should be performed immediately neuroimaging: such as CT, MRI diagnosis as soon as possible, as soon as possible treatment. Serum D-dimer, fibrinogen, HDL-C test may have some predictive significance.