Comparative Study Of Anticoagulant Therapy Combined With Anti-infective Therapy And Interventional Therapy In The Treatment Of Cerebral Venous Sinus Thrombosis

Objective(s):By comparing the two programs of anticoagulation combined with anti-infective therapy and interventional therapy(thrombolysis and mechanical thrombectomy),analyze the discharge prognosis,neural functional recovery,venous sinus recanalization,treatment cost and disease course,etc.,for treating Cerebral venous sinus thrombosis(CVST).Discuss the relevant differences,so as to provide basis for the choice of the two programs.Methods: The case data of all CVST patients in a general Grade A hospital in Kunming City,Yunnan Province from 2016 to 2022 were retrospectively investigated.According to the digital subtraction angiography(DSA)or magnetic resonance imaging on veins(MRV)imaging examination,clinical symptoms and signs,imaging of venous reflux obstacle,At the same time,the screening criteria such as anticoagulant therapy combined with anti-infective therapy or interventional therapy were adopted,and 42 patients meeting the requirements were selected to enter the study.There were 25 cases in the first one group and 17 cases in another one group.After a series of treatments,patients were evaluated according to the modified Rankin scale score(m RS)at admission and discharge,The National Institutes of Health Stroke Scale(NIHSS),The Reaction Leuel Scale(RLS),muscle strength of limbs and venous sinus recanalization were used to determine the prognosis and neurological function recovery.The X2 test was used to compare the efficacy of the two methods.At the same time,the age、treatment cost and length of hospital stay were tested by independent sample t test to determine whether there was any difference between the two schemes.Results: In the NIHSS score,3 patients in the anticoagulant therapy combined with anti-infective therapy group got worse and 22 patients got better;9 patients in the interventional therapy group got worse and 8 patients got better;there was statistical significance in the recovery of neurological function between the two groups(P=0.011).In m RS Scores,5 patients in the first group got worse and 20 patients got better,and 9 patients in the second group got worse and 8 patients got better.There was a statistically significant difference in clinical prognosis between the two groups(P=0.026).In venous sinus recanalization,1 patient in the first group had been cleared,22 patients had been partially cleared,and 2 patients had not been cleared,3 patients in the second group had been cleared,12 patients had been partially cleared,and 2patients had not been cleared.There was no statistical significance in venous sinus recanalization between the two groups(P=0.287).In RLS rating,1 patient got worse and 24 patients got better in the first group,5 patients got worse and 12 patients got better in the second group,and the difference in consciousness recovery between the two groups was statistically significant(P=0.032).In the recovery of limb muscle strength,5 patients in the first group got worse and 20 patients got better,and 9patients in the second group got worse and 8 patients got better.There was statistical significance in the recovery of limb muscle strength between the two groups(P=0.026).After independent sample T-test,the results of age and length of hospital stay in the two groups were(t=0.105,p=0.920)and(t=1.570,p=0.130),respectively,without statistical significance.After independent sample t test,the result of hospitalization cost was(t=-3.500,p=0.020),which was statistically significant.Conclusion(s): 1.For patients with CVST,the anticoagulation combined with anti-infection treatment regimen is superior to the interventional thrombolysis regimen in terms of recovery of neurological function,clinical prognosis and recovery of daily living ability.2.There was no significant difference between anticoagulation combined with anti-infection regimen and interventional thrombolysis regimen in the treatment of CVST patients with sinus recanalization,age and length of hospital stay,but the treatment cost of the former regimen was significantly less than that of the latter.