摘要:Objective To study the clinical characteristics and treatment of cerebral venous sinus thrombosis (CVST) in pregnant and parturient women.Methods The clinical data of 32 pregnant women with CVST in Shangqiu First People's Hospital from Feb 2009 to May 2015 were analyzed retrospectively.Results Among the 32 patients,there were 30 cases with headache,in which 23 cases with vomit,3 cases with psychosis,12 cases with blurred vision,7 cases with unilateral or bilateral limb weakness?,6 cases with epileptic attack,10 cases with disorder of consciousness,5 cases with hemidysesthesia,17 cases with positive pathological sign,22 cases with papilloedema,and 5 cases with fever.CVST was diagnosed after the imaging examinations of CT,MRI/MRV and DSA.There were 19 patients underwent systemic anticoagulant therapy in which 16 were fully recovered,2 cases with dysfunction,1 patient of extensive CVST combined intracerebral hemorrhage and cerebral herniation was dead.There were 13 patients with heavy CVST received endovascular thrombolysis,in which 8 were fully recovered,5 cases with functional disturbance.3 early stage pregnant patients terminated the pregnancy timely in a stable condition.6 cases of patients with late pregnancy underwent caesarean section after assessing the possibility of fetal delivery,immediate cesarean section termination of pregnancy,5 cases of neonatal survived and 1 cases of premature death.Conclusion The clinical manifestations of CVST patients were variable and nonspecific,when pregnant women have nervous system symptoms and signs,such as unexplained headaches,the possibility of CVST should be suspected,and neuroimaging examination should be carried out early.According to the patient's condition and severity,anticoagulation and endovascular treatment timely could improved the prognosis of patients.%目的 探讨孕产妇合并颅内静脉窦血栓形成(cerebral venous sinus thrombosis,CVST)的临床特征及治疗对策.方法 对2009年2月至2015年5月在商丘市第一人民医院诊治的32例孕产妇合并CVST患者的临床资料进行回顾性分析.结果 32例患者中,表现为头痛30例,伴呕吐23例,精神异常3例,视物模糊12例,一侧或双侧肢体无力7例,痫性发作6例,意识障碍10例,感觉障碍5例,病理征阳性17例,视乳头水肿22例,合并发热5例,均经头颅CT、MRI/MRV及DSA检查确诊.19例患者采用单纯全身抗凝治疗,痊愈16例,存留功能障碍2例,1例颅内静脉窦广泛血栓合并脑内出血、脑疝形成重症患者经抢救无效死亡;13例重症患者行静脉窦内接触性溶栓治疗,痊愈8例,存留功能障碍5例;3例妊娠早期患者在病情稳定后终止妊娠;6例妊娠晚期患者评估胎儿产后有存活可能,立即行剖宫产终止妊娠,5例新生儿存活,1例早产儿死亡.结论 CVST临床表现复杂多样,缺乏特异性,当孕产妇出现不明原因的头痛等神经系统症状及体征时,应高度警惕CVST的可能,尽早行影像学检查确诊,根据患者的病情及严重程度及时行抗凝、多途径血管内治疗,可改善患者的预后.