中文摘要：

目的分析颅内静脉系统血栓形成合并脑出血患者在临床表现、危险因素、治疗方法和急性期预后方面的特点。方法研究入组确诊的颅内静脉系统血栓形成的患者75例,依据头部影像学将颅内静脉系统血栓形成患者分为不合并脑出血和合并出脑血两组。比较两组患者在人口学资料、潜在危险因素、临床表现、影像学特点、治疗方法和急性期预后的差异。最后分析颅内静脉系统血栓形成合并出血的高危因素。结果研究入组75例确诊的颅内静脉系统血栓形成患者,其中28例(37.2%)合并脑出血,47例(62.7%)不合并脑出血。合并出血组妊娠和产褥期患者的比例高(28.6%vs.6.4%,P=0.015),而不合并出血组感染的比例高(29.8%vs.7.1%,P=0.021)。合并出血组患者头痛(92.9%vs.70.2%,P=0.021)、意识障碍(25.0%vs.6.4%,P=0.034)、痫性发作(53.6%vs.19.1%,P=0.002)、运动障碍(35.7%vs.12.8%,P=0.019)更常见。此外,合并出血组累及多个静脉窦的比例较不合并出血组高(71.4%vs.44.7%,P=0.024),急性期预后较不合并出血组差(m RS≥3:46.4%vs.17.0%,P=0.006)。但是,合并出血组使用抗凝药物的18例患者中有12例急性期预后良好。二分类变量Logistic回归分析分析显示结果发现妊娠和产褥期(P=0.004)、多个静脉窦受累(P=0.007)与颅内静脉系统血栓形成合并出血成正相关,而感染(P=0.03)与出血成负相关。结论颅内静脉系统血栓形成合并脑出血组妊娠和产褥期患者的比例高,头痛、意识障碍、痫性发作、运动障碍、累及多个静脉窦更常见,而急性期预后更差。

英文摘要：

Objective To analyze the characteristics of clinical manifestations, risk factors, therapies and acute outcomes in patients with cerebral venous sinus thrombosis complicated by cerebral hemorrhage. Methods Seventy-five patients with cerebral venous sinus thrombosis were included in the study. According to the radiological findings on the brain image, patients were divided into two subgroups:cerebral hemorrhage group and non-hemorrhage group. The demo?graphic data, potential risk factors, clinical manifestations, radiological features, therapeutic strategies and acute out?comes were compared between two subgroups, and high risk factors were also analyzed. Results There were seventy-five patients with cerebral venous sinus thrombosis in the present study. Twenty-eight patients of them (37.2%) had cerebral hemorrhage whereas the remaining forty-seven patients (62.7%) did not have cerebral hemorrhage. Pregnancy/puerperi?um were significantly higher in patients with cerebral hemorrhage (with vs without;28.6%vs. 6.4%, P=0.015), while in?fection was markedly higher in patients without cerebral hemorrhage (with vs without;7.1% vs. 29.8%, P=0.021). Head?ache (92.9% vs. 70.2%, P=0.021), unconsciousness (25.0% vs. 6.4%,P=0.034), seizures (53.6% vs. 19.1%, P=0.002) and motor deficits (35.7% vs. 12.8%, P=0.019) were more common in patients with cerebral hemorrhage. Moreover, mul?tiple sinus involvement (1.4% vs. 44.7%, P=0.024) was significantly higher and the acute outcomes(mRS≥3: 46.4%vs.17.0%, P=0.006)were poorer in patients with cerebral hemorrhage. Binary Logistic analysis showed that pregnancy/pu?erperium (P=0.004) and multiple sinus involvement were positively, whereas infection was negatively correlated with cere?bral venous sinus thrombosis and hemorrhage ( P=0.007;P=0.03). Conclusions Pregnancy/puerperium, headache, uncon?sciousness, seizures, motor deficits and multiple sinus involvement are more frequently in patients with cerebral venous sinus thrombosis and hemorrhage, and the acute outcomes are poorer in