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中华脑血管病杂志(电子版) ›› 2022, Vol. 16 ›› Issue (02) : 141 -145. doi: 10.11817/j.issn.1673-9248.2022.02.016

病例报告

原发性血小板增多症并发脑梗死静脉溶栓治疗二例
赵广健1, 林范珍2, 张士瑞1, 王自然1,()   
  1. 1. 276000 山东临沂,山东省临沂市人民医院卒中中心
    2. 276000 山东临沂,山东省临沂市人民医院综合内科
  • 收稿日期:2022-02-28 出版日期:2022-04-01
  • 通信作者: 王自然

Intravenous thrombolytic therapy for essential thrombocytosis complicated with cerebral infarction: two case reports

Guangjian Zhao1, Fanzhen Lin2, Shirui Zhang1   

  • Received:2022-02-28 Published:2022-04-01
引用本文:

赵广健, 林范珍, 张士瑞, 王自然. 原发性血小板增多症并发脑梗死静脉溶栓治疗二例[J]. 中华脑血管病杂志(电子版), 2022, 16(02): 141-145.

Guangjian Zhao, Fanzhen Lin, Shirui Zhang. Intravenous thrombolytic therapy for essential thrombocytosis complicated with cerebral infarction: two case reports[J]. Chinese Journal of Cerebrovascular Diseases(Electronic Edition), 2022, 16(02): 141-145.

图1 例1患者2020年3月20日住院时骨髓涂片。示骨髓增生大致正常(约50%),粒细胞/红细胞比例大致正常,均以偏成熟阶段细胞为主;巨核细胞增多,各阶段巨核细胞均可见;间质少许淋巴细胞及浆细胞散在分布
图2 例1患者颅脑多模式CT成像。图a为颅脑CT平扫;图b为Alberta卒中项目早期CT评分7分;图c为CT血管成像示左侧颈内动脉未见显影;图d为CT血管成像示左侧大脑中动脉及大脑前动脉显影淡;图e为CT灌注成像示核心梗死区(局部脑血流量<30%)体积32 ml,低灌注区(脑血流达峰时间>6.0 s)体积240 ml,脑血流不匹配体积为208 ml(由RAPID软件提供)
图3 例1患者入院后第2天颅脑磁共振影像。图a、b、c分别为扩散加权成像,示左侧岛叶、额叶、颞叶高信号;图d、e、f分别为T1成像,示病变部位为低信号;图g、h、i分别为T2成像,示病变部位为高信号;图j、k、l为液体衰减反转恢复序列,示病变部位为高信号
图4 例2患者颅脑多模式CT成像。图a为颅脑CT平扫示左侧侧脑室前角低密度灶;图b为Alberta卒中项目早期CT评分9分;图c为CT血管成像未见明显大血管狭窄;图d为CT灌注成像(由RAPID软件提供)
图5 例2患者溶栓后颅脑CT平扫。示左侧基底节、颞叶及顶叶出血
图6 例2患者颅内血肿穿刺引流术后CT平扫
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