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1、儿童脑静脉窦血栓形成6例病例分析并文献复习纳玉辉戴梅熊晶晶王琚莫亚雄(昆明医科大学第一附属医院儿科云南昆明650032)【摘要】目的：探讨儿童脑静脉窦血栓形成(Cerebralvenoussinusthrombosis,CVST)的诱因、临床特征、诊断、治疗及近期预后。方法：回顾性分析2011年1月至2014年6月收住昆明医科大学第一附属医院儿科的6例CVST患儿临床资料。结果：4/6的CVST患儿为亚急性起病。4/6的患儿有上呼吸道/或消化道感染等诱因，2/6合并副鼻窦炎。6例患儿首发症状均为头痛
2、，66.7%有视乳头水肿和脑脊液压力增高。头颅MRI联合MRV显示病变多见于上矢状窦(4/6)、横窦(4/6)及乙状窦(3/6)。经抗凝、抗血小板、降低颅内压、抗感染及对症支持治疗，症状、体征好转，未遗留神经功能缺损。治疗后随访3个月，5/6的患儿影像学复查脑静脉显影好转。结论:儿童CVST以头痛、颅内压增高为主要表现，头颅MRI联合MRV检查是早期诊断儿童CVST最重要的手段。CVST首选的治疗方法是抗凝治疗，阿司匹林抗血小板治疗可用于儿童CVST。早期诊断和治疗有助于改善预后，治疗后应加强神经科
3、和眼科随访。【关键词】脑静脉窦血栓形成；儿童；诊断和治疗【中图分类号】R720.5【文献标识码】A【文章编号】2095-1752(2015)10-0073-04CerebralVenousSinusThrombosisInChildren:SixCaseReportandLiteratureReviewNaYuhui,DaiMei,XiongJingjing,WangJun,MoYaxiong.TheFirstAffiliatedHospitalofKunmingMedicalUniversity.
4、Kunming650032,China【Abstract】ObjectiveToinvestigatethecause,clinicalfeatures,diagnosis,treatmentandtheshort-termprognosisofcerebralvenoussinusthrombosis(CVST)inchildren.MethodsAretrospectivesurveywasperformedin6casesthatwerediagnosedwithCVSTinthepediat
5、ricwardofTheFirstAffiliatedHospitalofKunmingMedicalUniversityfromJan.2011toJun.2014.Results4/6ofthepatientsweresubacuteonset.4/6patientshadprecipitatingfactorsofupperrespiratorytractorgastrointestinalinfections,2/6patientscomplicatedwithsinusitis.6case
6、sofchildrenwithsymptomwereheadache,4/6hadpapillaryedemaandincreasedCSFpressure.MRIcombinedwithMRVshowedlesionsinthesuperiorsagittalsinus(4/6),thetransversesinus(4/6)andsigmoidsinus(3/6).Anticoagulation,antiplatelet,reducingintracranialpressure,antiinfe
7、ctionandsupportivetreatment,6casescured,noneuralfunctiondefect.Patientswerefollowedupfor3months,5/6childrenwithimprovedimagingofcerebralvenous.ConclusionCVSTinchildrenwithheadache,increasedintracranialpressureasthemainmanifestations,MRIcombinedwithMRVi
8、sthemostimportanttestsofearlydiagnosisinchildrenwithCVST.Anticoagulantisrecommendedasfirst-linetreatmentofCVST,AspirincanbeusedforchildrenwithCVST.Earlydiagnosisandtreatmentishelpfultoimprovetheprognosis.Theneurologyandophthalmologyafte
