Johnson M Cris, Parkerson Nikki, Ward Sarah, de Alarcon Pedro A
Department of Pediatrics, University of Virginia, Charlottesville, Virginia 22908-0386, USA.
J Pediatr Hematol Oncol. 2003 Apr;25(4):312-5. doi: 10.1097/00043426-200304000-00009.
To determine if anticoagulation therapy is effective for preventing progression of pediatric sinovenous thrombosis, to determine the safety of anticoagulation therapy in the pediatric population, and to outline risk factors and clinical presentation in the authors' population of patients with sinovenous thrombosis.
A retrospective chart review was conducted of 17 consecutive pediatric patients with sinovenous thrombosis at the authors' institution regardless of treatment option and outcome.
Fifteen children underwent anticoagulation therapy; two did not. Surgical intervention was undertaken in two patients. None of the children died. None had recurrence after anticoagulation was initiated. Of the patients who had follow-up studies performed, 33% had some resolution of the clot, 60% had complete resolution, and 13% had no change. Both children who did not undergo anticoagulation therapy had resolution of the thrombus. All of the children had improvement of their symptoms at presentation. No patient had worsening of radiologic findings during the follow-up period.
Anticoagulation therapy did not result in bleeding complications. Fifteen of 17 patients were safely anticoagulated. All children had improvement of their presenting symptoms. There was no worsening of radiologic findings in any patient, and there was improvement in 13 patients. One patient has long-term neurologic sequelae (a learning disability). This patient underwent extensive surgeries for subdural and epidural empyemas.
确定抗凝治疗对预防儿童窦静脉血栓形成进展是否有效，确定抗凝治疗在儿科人群中的安全性，并概述作者所在的窦静脉血栓形成患者群体的危险因素和临床表现。
对作者所在机构连续17例儿童窦静脉血栓形成患者进行回顾性病历审查，不考虑治疗方案和结果。
15名儿童接受了抗凝治疗；2名未接受。2名患者接受了手术干预。所有儿童均未死亡。开始抗凝治疗后均无复发。在进行随访研究的患者中，33%的患者血栓有部分溶解，60%完全溶解，13%无变化。2名未接受抗凝治疗的儿童血栓均已溶解。所有儿童在就诊时症状均有改善。随访期间无患者影像学表现恶化。
抗凝治疗未导致出血并发症。17例患者中有15例安全地接受了抗凝治疗。所有儿童的就诊症状均有改善。无患者影像学表现恶化，13例患者有改善。1例患者有长期神经后遗症（学习障碍）。该患者因硬膜下和硬膜外积脓接受了广泛手术。
